Hypophosphatemia

Aka: Hypophosphatemia, Low Serum Phosphorus

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II. Causes

  1. Starvation
  2. Diabetic Ketoacidosis
  3. Total Parenteral Nutrition (TPN)
  4. Insulin
  5. Nasogastric Suction (NG Suction)
  6. Diuretics
  7. Vomiting
  8. Vitamin D Deficiency
  9. Hypoparathyroid
  10. Pseudohypoparathyroidism
  11. Medications
    1. Corticosteroids
    2. Aluminum Hydroxide Antacids
  12. Gram Negative Sepsis

III. Evaluation

  1. Check Urinary Phosphate excretion (Urine Phosphorus)
  2. Low Urine Phosphorus: under 100 mg/d (FePO4 under 10%)
    1. Internal Redistribution
      1. Glucose administration
      2. Alkalosis
      3. DKA recovery
    2. Gastrointestinal Losses
      1. Malabsorption
      2. Vomiting
      3. Diarrhea
      4. Aluminum or MagnesiumAntacids
  3. High Urine Phosphorus: over 100mg/d (FePO4 over 20%)
    1. Check for wasting in urine of other Electrolytes
      1. Glucose
      2. Amino Acid
      3. Uric Acid
      4. Bicarbonate
    2. Electrolyte Wasting present
      1. Fanconi's Syndrome
        1. Idiopathic
        2. Sporadic
        3. Familial
      2. Cystinosis
      3. Amyloidosis
      4. Multiple Myeloma
      5. Wilson's Disease
      6. Nephrotic Syndrome
      7. Cadmium toxicity
      8. Acute Lead Toxicity
    3. Electrolyte Wasting absent
      1. Increased Serum Calcium
        1. Primary or ectopic Hyperparathyroidism
      2. Normal or Low Serum Calcium
        1. Secondary Hyperparathyroidism
        2. Androgen or Estrogen treatment
        3. Thiazide Diuretics
        4. Vitamin D resistant Rickets
        5. Post Acute Tubular Necrosis
        6. Post-transplant

IV. Management

  1. See Phosphorus Replacement

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Related Studies

Ontology: Hypophosphatemia (C0085682)

Definition (MSH) A condition of an abnormally low level of PHOSPHATES in the blood.
Definition (CSP) abnormally decreased amounts of phosphates in the blood; manifestations include hemolysis, lassitude, weakness, and convulsions.
Concepts Pathologic Function (T046)
MSH D017674
SnomedCT 4996001
English HYPOPHOSPHATAEMIA, Hypophosphatemias, HYPOPHOSPHATEMIA, hypophosphatemia, hypophosphatemia (diagnosis), Hypophosphatemia [Disease/Finding], disorder hypophosphatemia, hypophosphataemia, Disorder characterized by hypophosphatemia, Hypophosphatemia, Hypophosphataemia, Hypophosphatemia (disorder), Hypophosphatemia, NOS, Hypophosphataemia, NOS
French HYPOPHOSPHATEMIE, Hypophosphatémie
Portuguese HIPOFOSFATEMIA, Hipofosfatemia
Spanish HIPOFOSFATEMIA, hipofosfatemia (trastorno), hipofosfatemia, Hipofosfatemia
German HYPOPHOSPHATAEMIE, Hypophosphataemie, Hypophosphatäme
Japanese 低リン酸血症, ﾃｲﾘﾝｻﾝｹﾂｼｮｳ, ﾃｲﾘﾝｻﾝｹｯｼｮｳ
Swedish Hypofosfatemi
Finnish Hypofosfatemia
Russian GIPOFOSFATEMIIA, ГИПОФОСФАТЕМИЯ
Czech Hypofosfatemie, hypofosfatémie, hypofosfatemie
Croatian HIPOFOSFATEMIJA
Polish Hipofosfatemia
Hungarian Hypophosphataemia
Norwegian Hypofosfatemi
Dutch hypofosfatemie, Fosfatemie, hypo-, Hypofosfatemie
Italian Ipofosfatemia
Derived from the NIH UMLS (Unified Medical Language System)

Related Topics in Phosphorus Disorders

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