Hyperphosphatemia: Difference between revisions
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==Background== | ==Background== | ||
* | ===Major Causes=== | ||
*Increased phosphate intake (Vitamin D, laxative abuse) | |||
*Increased renal reabsorption ([[Hypoparathyroidism]]) | |||
*Decreased excretion ([[Renal failure]]) | |||
*Transcellular shifts ([[Tumor lysis syndrome]], [[Rhabdomyolysis]]) | |||
== | ==Clinical Features== | ||
*[[Fatigue]] | |||
*[[Shortness of breath]] | |||
*Anorexia | |||
*[[Nausea]] | |||
*[[Vomiting]] | |||
*[[Insomnia]] | |||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
*[[Calciphylaxis]] | *[[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]] | |||
*Metabolic Panel (with calcium, Magnesium, and Phosphorus) | |||
==Management== | |||
{{Hyperphosphatemia treatment}} | |||
==Disposition== | |||
==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
- Increased phosphate intake (Vitamin D, laxative abuse)
- Increased renal reabsorption (Hypoparathyroidism)
- Decreased excretion (Renal failure)
- Transcellular shifts (Tumor lysis syndrome, Rhabdomyolysis)
Clinical Features
- Fatigue
- Shortness of breath
- Anorexia
- Nausea
- Vomiting
- Insomnia
Differential Diagnosis
- Calciphylaxis
- Vitamin D intoxication
- Tumor lysis syndrome
- Laxative (Phospho-soda) abuse
- Rhabdomyolysis
- Hypoparathyroidism
- Pseudohypoparathyroidism
- Multiple myeloma
Evaluation
- >4.5mg/dL[1]
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
- ↑ Hawley C. Serum phosphate. Nephrology. Apr 2006. 11(S1):S201-5.