Deregulated Renal Calcium and Phosphate Transport during Experimental Kidney Failure

Impaired mineral homeostasis and inflammation are hallmarks of chronic kidney disease (CKD), yet the underlying mechanisms of electrolyte regulation during CKD are still unclear. Here, we applied two different murine models, partial nephrectomy and adenine-enriched dietary intervention, to induce kidney failure and to investigate the subsequent impact on systemic and local renal factors involved in Ca2+ and P-i regulation. Our results demonstrated that both experimental models induce features of CKD, as reflected by uremia, and elevated renal neutrophil gelatinase-associated lipocalin (NGAL) expression. In our model kidney failure was associated with polyuria, hypercalcemia and elevated urinary Ca2+ excretion. In accordance, CKD augmented systemic PTH and affected the FGF23-alpha klotho-vitamin-D axis by elevating circulatory FGF23 levels and reducing renal alpha klotho expression. Interestingly, renal FGF23 expression was also induced by inflammatory stimuli directly. Renal expression of Cyp27b1, but not Cyp24a1, and blood levels of 1,25-dihydroxy vitamin D-3 were significantly elevated in both models. Furthermore, kidney failure was characterized by enhanced renal expression of the transient receptor potential cation channel subfamily V member 5 (TRPV5), calbindin-D-28k, and sodium-dependent P-i transporter type 2b (NaP(i)2b), whereas the renal expression of sodium-dependent P-i transporter type 2a (NaP(i)2a) and type 3 (PIT2) were reduced. Together, our data indicates two different models of experimental kidney failure comparably associate with disturbed FGF23-alpha klotho-vitaminD signalling and a deregulated electrolyte homeostasis. Moreover, this study identifies local tubular, possibly inflammation-or PTH- and/or FGF23-associated, adaptive mechanisms, impacting on Ca2+/P-i homeostasis, hence enabling new opportunities to target electrolyte disturbances that emerge as a consequence of CKD development.