Current concepts of regulation of phosphate transport in renal proximal tubules.

The wealth of new information on BBM transport of Pi which has accumulated in recent years gives an indication of the importance and intellectual challenge that the mechanism of this process poses to investigators. In this brief reflection on the field, we have tried to draw attention to some general principles and features which may be helpful as working hypotheses in the development of the field. To date, a disproportionate amount of effort may have been spent on deciphering putative intracellular regulatory mechanisms, without knowing some essential fundamental properties of the Na+-Pi-COT. We suggest that a major effort should be exerted towards elucidating biogenesis of the Na+-Pi-COT, the possible existence of a membrane cycling mechanism, and a refined analysis of the Na+-Pi-COT in specific subsegments of proximal tubules. Advances in these areas together with studies of both the rapid and long-term adaptive regulation of Pi transport are needed, given the central role of the kidney in total body Pi homeostasis both in health and disease.