Rare diseases of phosphate/calcium metabolism correspond to a wide and heterogeneous spectrum of diseases. Recent knowledge in physiology and genetics has made it possible to better characterize them and to propose attractive therapeutic approaches based on the underlying pathophysiology. These diseases are often at the interface between nephrology and endocrinology. In this spirit of a multidisciplinary care, each specialty can bring its own critical point of view and its own specificities to improve patient care. The objective of this manuscript is to “read” with a nephrologist's point of view the main frameworks of diseases of phosphate/calcium metabolism, to illustrate the three crucial messages of nephro-protection sent to endocrinologists. First, calciuria must be interpreted both in absolute value (concentration hypercalciuria) and in ratio (flow hypercalciuria). Second, renal monitoring of therapies inducing hypercalciuria on kidneys with normal renal function (e.g. active vitamin D analogs or teriparatide) should be systematic. Last, hyperphosphatemia, often latent in hypoparathyroidism and pseudo-hypoparathyroidism, should be detected and at least benefit from dietary measures, in the context of Western diets rich in phosphate hidden in food additives.

磷酸盐/钙代谢的罕见疾病对应于广泛且异质的疾病谱。最近在生理学和遗传学方面的知识使得更好地表征它们并基于潜在的病理生理学提出有吸引力的治疗方法成为可能。这些疾病通常处于肾脏病学和内分泌学之间的交界处。本着多学科护理的精神，每个专业都可以提出自己的批判性观点和自己的特点来改善患者护理。这份手稿的目的是从肾脏病学家的角度“阅读”磷酸盐/钙代谢疾病的主要框架，以说明发送给内分泌学家的肾脏保护的三个关键信息。第一的，钙尿症必须从绝对值（浓度高钙尿症）和比率（流量高钙尿症）两个方面来解释。其次，对肾功能正常的肾脏引起高钙尿症的疗法（例如活性维生素 D 类似物或特立帕肽）的肾脏监测应该是系统性的。最后，高磷血症，通常潜伏在甲状旁腺功能减退症和假性甲状旁腺功能减退症中，在西方饮食中富含隐藏在食品添加剂中的磷酸盐的背景下，应该检测并至少从饮食措施中受益。