There have been numerous mechanisms that have been involved in the maintenance of serum phosphate in the normal and ideal range. This is basically made possible by regulating the phosphate absorption in the gut and tubular phosphate reabsorption in the kidney. There is a process by which phosphate in the gut is regulated and hence, at the same time, it is absorbed by the process of paracellular diffusion and active process of exchange which happens across the membranes of the cells. There have been various studies conducted to prove the correlation between the sodium-dependenat co-transporters and at the same time, NPT 2a and NPT 2c. These all are expressed at the apical membrane of the proximal tubule. There is always a provision for lack of the PTH activity and hence, the studies and the research reveal that 5-9 percent of the deficiencies occur because of this mechanism only. There has been an additional synthesis of VItamin D which plays a vital role in providing for the mechanism in the best possible manner. This can at the same time result in hyperphosphaturia and hypophosphatemia.
Ref art: https://www.kidney-international.org/article/S0085-2538(20)31198-4/fulltext
