Hyperphosphatemia
Revision as of 10:41, 24 July 2016 by Neil.m.young (talk | contribs) (Text replacement - "==Diagnosis==" to "==Evaluation==")
Background
- >4.5mg/dL[1]
Major Causes
- Increased phosphate intake (Vitamin D, laxative abuse
- Decreased excretion (Renal failure
- Transcellular shifts (Tumor lysis syndrome, Rhabdomyolysis)
Differential Diagnosis
- Calciphylaxis
- Vitamin D intoxication
- Tumor lysis
- Laxative (Phospho-soda) abuse
- Rhabdomyolysis
- Hypoparathyroidism
- Pseudohypoparathyroidism
- Multiple myeloma
Evaluation
Labs
Symptoms usually related to associated renal failure, hypocalcemia or hypomagnesemia
- Metabolic Panel (with calcium, Magnesium, and Phosphorus)
Signs and Symptoms
- Fatigue
- Shortness of breath
- Anorexia
- Nausea
- Vomiting
- Insomnia
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
References
- ↑ Hawley C. Serum phosphate. Nephrology. Apr 2006. 11(S1):S201-5.