Plasma level and renal handling of Pi: effect of overnight fasting with and without Pi supply

Abstract

Overnight fasting significantly increases plasma inorganic phosphate ([Pi]p) in rats previously fed low Pi diet (LPD), whereas it slightly decreases [Pi]p in rats previously fed high Pi diet (HPD). We assessed the role of the kidney in these differing responses by investigating the influence of overnight fasting on renal tubular capacity to reabsorb Pi by clearance technique in conscious rats. To also evaluate the effect of Pi deprivation during overnight fasting three groups of animals were studied: fed, completely fasted, and fasted with a Pi supply in the drinking water. In intact LPD and HPD rts the tubular Pi reabsorptive capacity was not different between fed and completely fasted rats. It was, however, found to be lower in fasted but Pi-supplied than in fed animals, indicating a decrease by overnight fasting with respect to all nutrients except Pi, i.e., by fasting per se. Conversely, it was higher in the animals completely fasted than in those fasted but Pi-supplied, showing an increase by overnight Pi deprivation. These two opposite effects explain the absence of any significant influence of overnight complete fasting on tubular Pi handling. The same results were obtained in thyroparathyroidectomized rats on low Pi intake. This study shows that the kidney can adapt its transport capacity for Pi according to changes in Pi supply within 12 h. It also suggests that it may react by a decrease in reabsorption to the reduction in Pi utilization that can be expected to occur during fasting per se. Furthermore, our data explain how the kidney, by adapting its tubular Pi transport to the prior dietary intake of Pi, can account for the difference in phosphatemic response to overnight fasting and consequently in the diurnal fluctuation of [Pi]p observed between LPD and HPD animals.