PAPEL DO FOSFATO NA DOENÇA CARDIOVASCULAR: MARCADOR OU CAUSADOR DE LESÃO?

Phosphate is an essential intracellular mineral that plays its role in a variety of metabolic pathways, like energy production and intracellular synthetis, apart from being and important block to various intracellular elements. Homeostasis of Pi, strictly regulated by parathormone, vitamin D and fibroblast growth factor 23, suffers greatly by the decline of renal function, as seen when phosphate overload and hyperphosphatemia takes its place. We will discuss the major clinical and experimental evidence that points to Pi as the newest villain of cardiovascular disease in the chronic renal disease population, as well as the population in general. Therapeutic strategies should be directed mainly in the reduction of Pi intake, that finds itself increased nowadays due to the presence of food preservatives based on this element in industrialized food. Populational studies are urgently needed to test in a more broad way the possible benefic effects of Pi overload control on cardiovascular system.