Hyperphosphatemia

Hyperphosphatemia
Phosphate group chemical structure
Classification and external resources
ICD-9	275.3
DiseasesDB	20722
eMedicine	med/1097
MeSH	D054559

Hyperphosphatemia is an electrolyte disturbance in which there is an abnormally elevated level of phosphate in the blood.^[1] Often, calcium levels are lowered (hypocalcemia) due to precipitation of phosphate with the calcium in tissues. Average phosphorus levels should be between 0.81 mmol/L and 1.45 mmol/L.

Signs and symptoms

Signs and symptoms include ectopic calcification, secondary hyperparathyroidism, and renal osteodystrophy.

Causes

Causes of hyperphosphatemia^[2]
Impaired renal phosphate excretion	Renal insufficiency Hypoparathyroidism Developmental Autoimmune After neck surgery or radiation Activating mutations of the calcium-sensing receptor Parathyroid suppression Parathyroid-independent hypercalcemia Vitamin D or vitamin A intoxication Sarcoidosis, other granulomatous diseases Immobilization, osteolytic metastases Milk-alkali syndrome Severe hypermagnesemia or hypomagnesemia Pseudohypoparathyroidism Acromegaly Tumoral calcinosis Heparin therapy
Massive extracellular fluid phosphate loads	Rapid administration of exogenous phosphate (intravenous, oral, rectal) Extensive cellular injury or necrosis Crush injuries Rhabdomyolysis Hyperthermia Fulminant hepatitis Cytotoxic therapy Severe hemolytic anemia Transcellular phosphate shifts Metabolic acidosis Respiratory acidosis

Hypoparathyroidism: In this situation, there are low levels of Parathyroid hormone (PTH). PTH normally inhibits reabsorption of phosphate by the kidney. Therefore, without enough PTH there is more reabsorption of the phosphate leading to a high phosphate level in the blood.

Chronic renal failure: When the kidneys are not working well, there will be increased phosphate retention.

Drugs: hyperphosphatemia can also be caused by taking oral sodium phosphate solutions prescribed for bowel preparation for colonoscopy in children.

Treatment

High phosphate levels can be avoided with phosphate binders and dietary restriction of phosphate.

References

↑ "hyperphosphatemia" at Dorland's Medical Dictionary
↑ Longo et al., Harrison's Principles of Internal Medicine, 18th ed., p.3089

Inborn error of metal metabolism (E83, 275)

Transition metal

high:	Primary iron overload disorder: Hemochromatosis/HFE1 Juvenile/HFE2 HFE3 African iron overload/HFE4 Aceruloplasminemia Atransferrinemia Hemosiderosis

deficiency:	Iron deficiency

high:	Copper toxicity Wilson's disease

deficiency:	Copper deficiency Menkes disease/Occipital horn syndrome

high:	Zinc toxicity

deficiency:	Acrodermatitis enteropathica

Electrolyte

Na⁺ and K⁺

see Template:Water-electrolyte imbalance and acid-base imbalance

PO₄³⁻

high:	Hyperphosphatemia

deficiency:	Hypophosphatemia alkaline phosphatase Hypophosphatasia

Mg²⁺

high:	Hypermagnesemia

deficiency:	Hypomagnesemia

Ca²⁺

high:	Hypercalcaemia Milk-alkali syndrome (Burnett's) Calcinosis (Calciphylaxis, Calcinosis cutis) Calcification (Metastatic calcification, Dystrophic calcification) Familial hypocalciuric hypercalcemia

deficiency:	Hypocalcaemia Osteomalacia Pseudohypoparathyroidism (Albright's hereditary osteodystrophy) Pseudopseudohypoparathyroidism

Index of nutrition

Description	Vitamins metabolism Cofactors Metal metabolism Fats metabolism intermediates lipoproteins Sugars Glycolysis enzymes Glycogenesis and glycogenolysis intermediates Fructose and galactose intermediates

Disease	Vitamins Carbohydrate Lipid storage Metals Other Symptoms and signs eponymous

Treatment	Drugs obesity lipid-modifying Vitamins Mineral supplements

Hyperphosphatemia

Signs and symptoms

Causes

Treatment

See also

References