II. Causes

  1. Renal Failure
  2. Dehydration
  3. Addison's Disease
  4. Hypervitaminosis D
  5. Hypoparathyroid
  6. Magnesium deficiency
  7. Milk-Alkali Syndrome
  8. Transfusions
  9. Hemolysis
  10. Sarcoidosis
  11. Bone metastases
  12. Myelogenous Leukemia

III. Evaluation: Renal Failure

  1. Chronic Renal Failure
    1. Increased phosphate when GFR falls below 20 ml/min
    2. Usually Phosphate in 5-10 mg/dl range
  2. Acute Renal Failure
    1. Especially in oliguric or hypercatabolic forms
    2. Highest in:
      1. Myoglobinuric Acute Tubular Necrosis
      2. Surgery
      3. Trauma

IV. Evaluation: Normal Renal Function

  1. Check Urinary phosphate excretion (Urine pHosphate)
  2. Increased Urine pHosphate: over 1500 mg/dl
    1. Endogenous source
      1. Cytotoxins
      2. Rhabdomyolysis
      3. Malignant hyperpyrexia (Fever)
    2. Exogenous source
      1. Laxative Abuse
      2. Enemas
      3. Phosphate (Oral, IV, or Poisoning)
  3. Normal Urine pHosphate: Under 1500mg/dl
    1. Increased reabsorption
      1. Hyperparathyroidism
      2. Menopause
      3. Extracellular Fluid Volume contraction
      4. Tumoral calcinosis

V. Management

  1. Antacid binding gel: Aluminum hydroxide (AlternaGel)
    1. Dose 600 mg/5 ml, 5 ml qid with meals and at bedtime
  2. Low Phosphate diet

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Ontology: Hyperphosphatemia (disorder) (C0085681)

Definition (NCI) Abnormally high level of phosphate in the blood.
Definition (MSH) A condition of abnormally high level of PHOSPHATES in the blood, usually significantly above the normal range of 0.84-1.58 mmol per liter of serum.
Concepts Disease or Syndrome (T047)
MSH D054559
SnomedCT 20165001
English HYPERPHOSPHATAEMIA, HYPERPHOSPHATEMIA, Hyperphosphatemia, Hyperphosphatemias, hyperphosphatemia, hyperphosphatemia (diagnosis), Hyperphosphatemia [Disease/Finding], hyperphosphataemia, Hyperphosphatemia (disorder), Hyperphosphataemia
Japanese 高リン酸塩血症, コウリンサンエンケツショウ, コウリンサンエンケッショウ
Portuguese Hiperfosfatemia, HIPERFOSFATEMIA
Spanish Hiperfosfatemia, HIPERFOSFATEMIA, hiperfosfatemia (trastorno), hiperfosfatemia
Finnish Hyperfosfatemia
French Hyperphosphatémie, HYPERPHOSPHATEMIE
German Hyperphosphatämie, HYPERPHOSPHATAEMIE, Hyperphosphataemie
Italian Iperfosfatemia
Russian ГИПЕРФОСФАТЕМИЯ, GIPERFOSFATEMIIA
Swedish Hyperfosfatemi
Czech Hyperfosfatemie, hyperfosfatémie
Polish Hiperfosfatemia
Hungarian Hyperphosphataemia
Norwegian Hyperfosfatemi
Dutch hyperfosfatemie