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Hyperphosphatemia
Aka: Hyperphosphatemia, High Serum Phosphorus
- Causes
- Renal Failure
- Dehydration
- Addison's Disease
- Hypervitaminosis D
- Hypoparathyroid
- Magnesium deficiency
- Milk-Alkali Syndrome
- Transfusions
- Hemolysis
- Sarcoidosis
- Bone metastases
- Myelogenous Leukemia
- Evaluation: Renal Failure
- Chronic Renal Failure
- Increased phosphate when GFR falls below 20 ml/min
- Usually Phosphate in 5-10 mg/dl range
- Acute Renal Failure
- Especially in oliguric or hypercatabolic forms
- Highest in:
- Myoglobinuric Acute Tubular Necrosis
- Surgery
- Trauma
- Evaluation: Normal Renal Function
- Check Urinary phosphate excretion (Urine pHosphate)
- Increased Urine pHosphate: over 1500 mg/dl
- Endogenous source
- Cytotoxins
- Rhabdomyolysis
- Malignant hyperpyrexia (Fever)
- Exogenous source
- Laxative Abuse
- Enemas
- Phosphate (Oral, IV, or Poisoning)
- Normal Urine pHosphate: Under 1500mg/dl
- Increased reabsorption
- Hyperparathyroidism
- Menopause
- Extracellular Fluid Volume contraction
- Tumoral calcinosis
- Management
- Antacid binding gel: Aluminum hydroxide (AlternaGel)
- Dose 600 mg/5 ml, 5 ml qid with meals and at bedtime
- Low Phosphate diet