Hyperphosphatemia

Hyperphosphatemia

Phosphate group chemical structure
Classification and external resources
ICD-9-CM	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. Abnormalities in phosphate metabolism such as hyperphosphatemia are included in the definition of the new chronic kidney disease-mineral and bone disorder (CKD-MBD).^[2]

Causes

Impaired renal phosphate excretion^[3]	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^[3]	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

↑ "Hyperphosphataemia at The Free Dictionary" Retrieved on 09 June 2016
↑ "KDIGO Guideline for Chronic Kidney Disease-Mineral and Bone Disorder (CKD-MBD)". Retrieved 7 February 2016.
1 2 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

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Hyperphosphatemia

Signs and symptoms

Causes

Treatment

See also

References