The Anemia of Childhood — Evidence for a Physiologic Response to Hyperphosphatemia

Minor increases in plasma inorganic phosphate concentration produce major alterations in red-cell metabolism in vitro and lead to raised levels of red-cell adenosine triphosphate and 2,3-diphosphoglycerate in vivo, with a resultant shift in the hemoglobin-oxygen dissociation curve to the right. Normal children have plasma phosphates 50 per cent above the normal adult range. Studies were performed to determine whether this hyperphosphatemia …