{"id":"e8e2884f-1da2-5ebf-9b60-5afbba4f9731","stable_key":"e13b03e1-a614-543a-ac1b-97df18cfe30d:iron-fgf23-phosphate-loss","predicate":"associated_with","statement":"The rise in active FGF23 was associated with increased renal phosphate wasting and hypophosphatemia.","claim_class":"observational","status":"source_derived_draft","evidence_grade":"ungraded","direction":"context_dependent","is_public":true,"mechanism_event_id":"d8e36dc2-d694-5c5e-bc1e-913a441bc4ba","mechanism_event_label":"More phosphate was being lost through the kidneys as the hormone rose.","subject":{"id":"fe53ea97-98c6-5545-a40f-d4e43129d32d","slug":"circulating-intact-fgf23","display_name":"Circulating biologically active intact FGF23","entity_type_key":"cellular_process"},"object":{"id":"60b82331-e8a4-52b0-8b58-f5be875194d5","slug":"renal-phosphate-wasting","display_name":"Renal phosphate wasting","entity_type_key":"cellular_process"},"evidence_count":1,"mechanism_event":{"id":"d8e36dc2-d694-5c5e-bc1e-913a441bc4ba","stable_key":"e13b03e1-a614-543a-ac1b-97df18cfe30d:iron-fgf23-phosphate-loss-event","event_type":"observed_intervention","label":"More phosphate was being lost through the kidneys as the hormone rose.","description":"The rise in active FGF23 was associated with increased renal phosphate wasting and hypophosphatemia.","status":"provisional","compartment":null,"participants":[{"entity":{"id":"b28dfc54-a5ef-5f9e-ac1f-890b68e58dc3","slug":"inorganic-phosphate","display_name":"Inorganic phosphate","entity_type_key":"chemical_species"},"role":"lost_mineral","stoichiometry":null,"state_label":"","sequence_order":0,"notes":""},{"entity":{"id":"fe53ea97-98c6-5545-a40f-d4e43129d32d","slug":"circulating-intact-fgf23","display_name":"Circulating biologically active intact FGF23","entity_type_key":"cellular_process"},"role":"subject","stoichiometry":null,"state_label":"","sequence_order":1,"notes":""},{"entity":{"id":"60b82331-e8a4-52b0-8b58-f5be875194d5","slug":"renal-phosphate-wasting","display_name":"Renal phosphate wasting","entity_type_key":"cellular_process"},"role":"target","stoichiometry":null,"state_label":"","sequence_order":2,"notes":""}]},"contexts":[{"dimension":"availability_state","value_text":"nutrient_deficiency","comparator":null,"unit":null,"notes":"Imported condition classification; unverified.","entity":null},{"dimension":"evidence_span","value_text":"{\"source_cache\": \"artifacts/iron-research/30518682.abstract.txt\", \"locator\": \"Exact primary indexed abstract; zero-based, end-exclusive Unicode character offsets\", \"file_sha256\": \"489945718bb05c0630fd563dc5a6da0874e80685717ab06ceedfefc38d172257\", \"start_char\": 0, \"end_char\": 2371, \"text_sha256\": \"489945718bb05c0630fd563dc5a6da0874e80685717ab06ceedfefc38d172257\"}","comparator":null,"unit":null,"notes":"","entity":null},{"dimension":"experimental_model","value_text":"Double-blind randomized comparison with physiological substudy","comparator":null,"unit":null,"notes":"","entity":null},{"dimension":"exposure","value_text":"One treatment course of ferric carboxymaltose versus ferumoxytol; five-week follow-up","comparator":null,"unit":null,"notes":"","entity":null},{"dimension":"limitations","value_text":"Formulation-specific pharmacological effect, not dietary iron or all intravenous iron. Trial funded by ferumoxytol manufacturer; mineral associations support but do not individually prove every causal arrow.","comparator":null,"unit":null,"notes":"","entity":null},{"dimension":"nutrient_topic","value_text":"Iron research collection; topical membership is not evidence of a direct dietary effect.","comparator":null,"unit":null,"notes":"","entity":{"slug":"iron","display_name":"Iron","entity_type_key":"nutrient_element"}},{"dimension":"organism","value_text":"1997 adults with iron-deficiency anemia; 185 in substudy","comparator":null,"unit":null,"notes":"","entity":null},{"dimension":"plain_language","value_text":"More phosphate was being lost through the kidneys as the hormone rose.","comparator":null,"unit":null,"notes":"","entity":null},{"dimension":"primary_references","value_text":"[iron-p30518682] Randomized trial of intravenous iron-induced hypophosphatemia. (2018). https://pubmed.ncbi.nlm.nih.gov/30518682/ DOI: 10.1172/jci.insight.124486","comparator":null,"unit":null,"notes":"","entity":null},{"dimension":"tissue_or_cell_type","value_text":"Blood and renal phosphate handling","comparator":null,"unit":null,"notes":"","entity":null},{"dimension":"trigger_kind","value_text":"nutrient_deficiency","comparator":null,"unit":null,"notes":"Imported condition classification; unverified.","entity":null}],"evidence":[{"id":"f6ae9194-f431-5aff-9572-41e5ace2ba25","evidence_kind":"source_excerpt","locator":"Lines 966-977","start_line":966,"end_line":977,"excerpt":"### iron-fgf23-phosphate-loss\nThe rise in active FGF23 was associated with increased renal phosphate wasting and hypophosphatemia.\nCondition category: nutrient_deficiency\nnutrient_topic: Iron research collection; topical membership is not evidence of a direct dietary effect.\nplain_language: More phosphate was being lost through the kidneys as the hormone rose.\norganism: 1997 adults with iron-deficiency anemia; 185 in substudy\ntissue_or_cell_type: Blood and renal phosphate handling\nexperimental_model: Double-blind randomized comparison with physiological substudy\nlimitations: Formulation-specific pharmacological effect, not dietary iron or all intravenous iron. Trial funded by ferumoxytol manufacturer; mineral associations support but do not individually prove every causal arrow.\nexposure: One treatment course of ferric carboxymaltose versus ferumoxytol; five-week follow-up\nevidence_span: {\"source_cache\": \"artifacts/iron-research/30518682.abstract.txt\", \"locator\": \"Exact primary indexed abstract; zero-based, end-exclusive Unicode character offsets\", \"file_sha256\": \"489945718bb05c0630fd563dc5a6da0874e80685717ab06ceedfefc38d172257\", \"start_char\": 0, \"end_char\": 2371, \"text_sha256\": \"489945718bb05c0630fd563dc5a6da0874e80685717ab06ceedfefc38d172257\"}\n[iron-p30518682] Randomized trial of intravenous iron-induced hypophosphatemia. 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