Phosphate - Hyperphosphataemia

Hyperphosphatemia often occurs in association with low calcium precipitation of phosphate with the calcium in tissues. Average phosphorus levels should be between 0.81 mmol/L and 1.45 mmol/L.

Causes of hyperphosphatemia

• Renal insufficiency

  • ?Hypoparathyroidism

• Parathyroid suppression

• Severe hypermagnesemia or hypomagnesemia

  • Pseudohypoparathyroidism

  • Acromegaly

  • Tumoral calcinosis

  • Heparin therapy

Massive extracellular fluid phosphate loads

• Rapid administration of exogenous phosphate (intravenous, oral, rectal)

• Extensive cellular injury or necrosis

  • Crush injuries

  • Rhabdomyolysis

  • Hyperthermia

  • Fulminant hepatitis

  • Cytotoxic therapy

  • Severe hemolytic anemia

• ?Transcellular phosphate shifts

  • Metabolic acidosis

  • Respiratory acidosis

Management

High phosphate levels are avoided with phosphate binders and dietary restriction of phosphate.