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Serum phosphate refers to the concentration of inorganic phosphate ions circulating in the blood. Phosphate (PO4) is a small, electrically charged mineral essential for numerous biological processes, including building bones and teeth, energy production (as ATP), acid-base balance, muscle contraction, and intracellular signaling. Most phosphate in the body is stored in bone in complex with calcium, and only a small fraction circulates the blood as inorganic phosphate. Kidneys, intestines, bone, and parathyroid glands tightly regulate serum phosphate through membrane transporters and three key hormones: parathyroid hormone, vitamin D (calcitriol), and fibroblast growth factor 23 (FGF23)[12]. Abnormal serum phosphate signals underlying systemic disease, most commonly kidney dysfunction, and may result in metabolic bone disorders, cardiovascular disease, and acute neuromuscular emergencies if severely abnormal[1][3][5][7][15]. Serum phosphate itself is not a molecular target for therapeutic drugs; rather, it is a diagnostic marker used to monitor disease states and the effects of drugs that alter phosphate metabolism.
Phosphate binders: Reduce gastrointestinal absorption of phosphate, lowering serum levels Diuretics: Increase renal excretion of phosphate Vitamin D analogs: Increase intestinal absorption of phosphate
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