Circadian changes in plasma phosphate concentration, urinary phosphate excretion, and cellular phosphate shifts

The concentration of phosphate (Pi) in plasma, Pi excretion, and the tubular threshold of Pi resorption (TmP/GFR) all increase throughout the day from about 1100 to 0300 h. For plasma [Pi], cosinor analysis yielded the following estimates of the parameters of this pattern (with 95% confidence limits): amplitude = 0.17 (0.07-0.26) mmol/L, phase = peak at 0201 (1127-0342) h, and MESOR = 1.14 (1.11-1.18) mmol/L. The increase in TmP/GFR reflects an underlying change in renal Pi handling, which is not attributable to changes in parathyrin concentrations. The changes in Pi excretion work both for and against the changes in plasma [Pi], at different times. The calculated net nonrenal flux of Pi into the extracellular fluid increases in the morning and remains high until 0300 h, and neither it nor Pi excretion nor plasma [Pi] shows any relation to meals. This illustrates the importance of transient net fluxes of Pi between intracellular and extracellular spaces in the control of hour-to-hour changes of plasma [Pi].