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Salivary glands: a new player in phosphorus metabolism.
J Ren Nutr. 2011 Jan; 21(1):39-42.JR

Abstract

In uremic patients, hyperphosphatemia is associated with cardiovascular calcification and increased cardiovascular mortality. Despite the use of phosphate binders and dietary phosphate limitation in addition to dialysis, only 50% of dialysis patients achieve recommended serum phosphate levels. The identification of other approaches for serum phosphorus reduction is therefore necessary. We have approached this issue by taking into account the relationships between serum phosphate, kidney function, and saliva. Saliva was chosen because the anatomy and/or physiology of acini, the secretive units of salivary glands, shares similarities with that of the renal tubules. Salivary fluid contains electrolytes including phosphate that, when related with the amount of salivary secretion per day, raises the interest in identifying another possible approach for phosphorus removal in uremic patients. This article reports studies from our laboratory in the last 3 to 4 years, which have demonstrated a hyperphosphoric salivary content in patients with chronic renal failure and those with end-stage renal disease under chronic dialysis that, in patients with chronic renal failure, linearly correlates with serum phosphate in patients with chronic renal failure and negatively with GFR. The ingestion of the saliva and later its absorption in the intestinal tract starts a vicious circle between salivary phosphate secretion and fasting phosphate absorption, thereby worsening hyperphosphatemia. Therefore, salivary phosphate binding could be a useful approach to serum phosphate level reduction in dialysis patients. The reduction of salivary phosphate with the salivary phosphate binder, chitosan-loaded chewing gum, chewed during fasting periods, as an add-on to phosphate binders could lead to a better control of hyperphosphatemia, as demonstrated in our study, which confirms the importance of this approach.

Authors+Show Affiliations

Chair of Nephrology, University of Messina, Messina, Italy.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

21195917

Citation

Savica, Vincenzo, et al. "Salivary Glands: a New Player in Phosphorus Metabolism." Journal of Renal Nutrition : the Official Journal of the Council On Renal Nutrition of the National Kidney Foundation, vol. 21, no. 1, 2011, pp. 39-42.
Savica V, Calò LA, Santoro D, et al. Salivary glands: a new player in phosphorus metabolism. J Ren Nutr. 2011;21(1):39-42.
Savica, V., Calò, L. A., Santoro, D., Monardo, P., Santoro, G., Muraca, U., Davis, P. A., & Bellinghieri, G. (2011). Salivary glands: a new player in phosphorus metabolism. Journal of Renal Nutrition : the Official Journal of the Council On Renal Nutrition of the National Kidney Foundation, 21(1), 39-42. https://doi.org/10.1053/j.jrn.2010.11.007
Savica V, et al. Salivary Glands: a New Player in Phosphorus Metabolism. J Ren Nutr. 2011;21(1):39-42. PubMed PMID: 21195917.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Salivary glands: a new player in phosphorus metabolism. AU - Savica,Vincenzo, AU - Calò,Lorenzo A, AU - Santoro,Domenico, AU - Monardo,Paolo, AU - Santoro,Giuseppe, AU - Muraca,Ugo, AU - Davis,Paul A, AU - Bellinghieri,Guido, PY - 2011/1/4/entrez PY - 2011/1/5/pubmed PY - 2011/5/3/medline SP - 39 EP - 42 JF - Journal of renal nutrition : the official journal of the Council on Renal Nutrition of the National Kidney Foundation JO - J Ren Nutr VL - 21 IS - 1 N2 - In uremic patients, hyperphosphatemia is associated with cardiovascular calcification and increased cardiovascular mortality. Despite the use of phosphate binders and dietary phosphate limitation in addition to dialysis, only 50% of dialysis patients achieve recommended serum phosphate levels. The identification of other approaches for serum phosphorus reduction is therefore necessary. We have approached this issue by taking into account the relationships between serum phosphate, kidney function, and saliva. Saliva was chosen because the anatomy and/or physiology of acini, the secretive units of salivary glands, shares similarities with that of the renal tubules. Salivary fluid contains electrolytes including phosphate that, when related with the amount of salivary secretion per day, raises the interest in identifying another possible approach for phosphorus removal in uremic patients. This article reports studies from our laboratory in the last 3 to 4 years, which have demonstrated a hyperphosphoric salivary content in patients with chronic renal failure and those with end-stage renal disease under chronic dialysis that, in patients with chronic renal failure, linearly correlates with serum phosphate in patients with chronic renal failure and negatively with GFR. The ingestion of the saliva and later its absorption in the intestinal tract starts a vicious circle between salivary phosphate secretion and fasting phosphate absorption, thereby worsening hyperphosphatemia. Therefore, salivary phosphate binding could be a useful approach to serum phosphate level reduction in dialysis patients. The reduction of salivary phosphate with the salivary phosphate binder, chitosan-loaded chewing gum, chewed during fasting periods, as an add-on to phosphate binders could lead to a better control of hyperphosphatemia, as demonstrated in our study, which confirms the importance of this approach. SN - 1532-8503 UR - https://www.unboundmedicine.com/medline/citation/21195917/Salivary_glands:_a_new_player_in_phosphorus_metabolism_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1051-2276(10)00308-0 DB - PRIME DP - Unbound Medicine ER -