Hyperphosphatemia: Difference between revisions

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==Background==
==Background==
*>4.5 mg/dL
===Major Causes===
*Increased phosphate intake (Vitamin D, laxative abuse)
*Increased renal reabsorption ([[Hypoparathyroidism]])
*Decreased excretion ([[Renal failure]])
*Transcellular shifts ([[Tumor lysis syndrome]], [[Rhabdomyolysis]])


==Diagnosis==
==Clinical Features==
*[[Fatigue]]
*[[Shortness of breath]]
*Anorexia
*[[Nausea]]
*[[Vomiting]]
*[[Insomnia]]
 
==Differential Diagnosis==
*[[Calciphylaxis]]
*Vitamin D intoxication
*[[Tumor lysis syndrome]]
*[[bulimia nervosa|Laxative (Phospho-soda) abuse]]
*[[Rhabdomyolysis]]
*[[Hypoparathyroidism]]
*Pseudo[[hypoparathyroidism]]
*[[Multiple myeloma]]
 
==Evaluation==
*>4.5mg/dL<ref>Hawley C. Serum phosphate. Nephrology. Apr 2006. 11(S1):S201-5.</ref>
===Labs===
Symptoms usually related to associated renal failure, [[hypocalcemia]] or [[hypomagnesemia]]
Symptoms usually related to associated renal failure, [[hypocalcemia]] or [[hypomagnesemia]]
*Metabolic Panel (with calcium, Magnesium, and Phosphorus)
==Management==
{{Hyperphosphatemia treatment}}


==Treatment ==
==Disposition==
#'''Treat the underlying cause'''
#Restrict calcium phosphate intake
#IV Normal Saline (if normal renal fx)
#Acetazolamide (500mg IV q6hr) - if normal renal fx
#Oral phosphate binders (aluminum carbonate or hydroxide)
#Hemodialysis


==Sources==
Tintinalli
==See Also==
==See Also==
*[[Electrolyte Abnormalities (Main)]]
*[[Electrolyte Abnormalities (Main)]]
==References==
<references/>


[[Category:FEN]]
[[Category:FEN]]

Latest revision as of 22:47, 9 June 2023

Background

Major Causes

Clinical Features

Differential Diagnosis

Evaluation

Labs

Symptoms usually related to associated renal failure, hypocalcemia or hypomagnesemia

  • Metabolic Panel (with calcium, Magnesium, and Phosphorus)

Management

Hyperphosphatemia treatment

  • Treat the underlying cause
  • Restrict calcium phosphate intake
  • IV Normal Saline (if normal renal fx)
  • Acetazolamide (500mg IV q6hr) - if normal renal function
  • Phosphate Binder - Aluminum hydroxide (50-150mg/kg PO q4-6h) - limited effect
  • Dialysis if refractory

Disposition

See Also

References

  1. Hawley C. Serum phosphate. Nephrology. Apr 2006. 11(S1):S201-5.