Nephrology Book

Abnormally Decreased

  • Hypophosphatemia

Abnormally Increased

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HypophosphatemiaAka: Low Serum Phosphorus

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  1. 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
  2. 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 Magnesium antacids
    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
  3. Management
    1. See Phosphorus Replacement

Hypophosphatemia (C0085682)

Definition (MSH)A condition of an abnormally low level of PHOSPHATES in the blood. Severe hypophosphatemia (below 1 mg/liter) can affect every organ in the body leading to HEMOLYSIS; LASSITUDE; SEIZURES; and COMA. Chronic hypophosphatemia can lead to MUSCLE WEAKNESS; and bone diseases, such as RICKETS and OSTEOMALACIA.
Definition (CSP)abnormally decreased amounts of phosphates in the blood; manifestations include hemolysis, lassitude, weakness, and convulsions.
Definition (NCI)Hypophosphatemia; lower than normal levels of phosphates in the circulating blood.
ConceptsFinding (T033)
MSHD017674
EnglishHYPOPHOSPHATAEMIA, Hypophosphatemia, Hypophosphatemias
Spanishhipofosfatemia
Parent ConceptsPhosphorus Metabolism Disorders (C0031707), Disease of parathyroid glands (C0030517), CALCIUM/PHOSPHATE ABNORMALITY (C0549633), Abnormal Blood Chemistry and Hematology Test Result (C1332129)
SourcesCOSTAR, CSP, CST, DXP, MSH, MTH, NCI, NDFRT, OMIM, SCTSPA, SNOMEDCT
Derived from the NIH UMLS (Unified Medical Language System)



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