Hyperphosphatemia
From Anvita Health Wiki
Contents |
Etiology
- dehydration
- increased absorption from gut (up to 45 mg/dL)
-
- phosphorous-containing cathartics
- milk-alkali syndrome
- phosphate-containing IV solutions
- decreased renal excretion
- renal failure
- hypoparathyroidism
- tumoral calcinosis
- pseudoxanthoma elasticum
- infantile hyperphosphatemia
- hyperostosis
- hyperthyroidism
- growth hormone excess/ acromegaly
- adrenal insufficiency
- increased binding to serum proteins with plasma cell dyscrasias
- increased release from bone
- osteolytic metastases to bone
- healing fractures
- diabetes mellitus with ketosis
- cellular release of phosphate
- metabolic acidosis including lactic acidosis
- acute respiratory acidosis
- drugs
Laboratory
-
- product serum Ca+2 ( mg/dL) x serum phosphate ( mg/dL) > 70 indicates risk of metastatic calcification
- metastatic calification more likely to occur with elevated pH
Complications
Management
- in the absence of renal insufficiency:
- volume expansion with hypotonic saline
- aluminum-based antiacids (Amphogel)
- to prevent absorption of phosphorous
- more effective short term than PhosLo
- low risk of metastatic calcification
- hemodialysis if renal insufficiency is present
Additional Terms
References
- Guide to Clinical Laboratory Tests, 3rd ed, NW Teitz (ed) WB Saunders, 1995
- Harrison's Principles of Internal Medicine, 14th ed. Fauci et al (eds), McGraw-Hill Inc. NY, 1998, pg 2262
- Medical Knowledge Self Assessment Program (MKSAP) 11, American College of Physicians, Philadelphia 1998
