Hyperphosphatemia

Hyperphosphatemia
Phosphate group chemical structure
Specialty Endocrinology Edit this on Wikidata

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/litre and 1.45 mmol/litre.

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]
Massive extracellular fluid phosphate loads[3]

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.

Diagnosis

The diagnosis of hyperphosphatemia is made through measuring the concentration of phosphate in the blood. A phosphate concentration greater than 1.46 mmol/L (4.5 mg/dL) is indicative of hyperphosphatemia, though further tests may be needed to identify the underlying cause of the elevated phosphate levels.[4]

Treatment

High phosphate levels can be avoided with phosphate binders and dietary restriction of phosphate.[4] If the kidneys are operating normally, a saline diuresis can be induced to renally eliminate the excess phosphate. In extreme cases, the blood can be filtered in a process called hemodialysis, removing the excess phosphate.[4]

See also

References

  1. ↑ "Hyperphosphataemia at The Free Dictionary" Retrieved on 09 June 2016
  2. ↑ "KDIGO Guideline for Chronic Kidney Disease-Mineral and Bone Disorder (CKD-MBD)". Retrieved 7 February 2016.
  3. 1 2 Longo et al., Harrison's Principles of Internal Medicine, 18th ed., p.3089
  4. 1 2 3 "Hyperphosphatemia - Endocrine and Metabolic Disorders - Merck Manuals Professional Edition". Merck Manuals Professional Edition. Merck Sharp & Dohme Corp. Retrieved 23 October 2017.
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External resources
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