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HYPOPHOSPHATEMIA & HYPERPHOSPHATEMIA

Hypophosphatemia is an electrolyte imbalance where there is a decrease in the serum phosphate level that is less than the normal range.

It is recognized most often in critically-ill patients, decompensated diabetics, alcoholics or other malnourished persons, and acute infectious or pulmonary disorders.

It may be transient and reflect intracellular shift with minimal clinical consequences.

Hyperphosphatemia is an electrolyte disturbance in which an increase in the serum phosphate level of more than the normal range is present.

Most symptoms of acute hyperphosphatemia are due to secondary hypocalcemia.

The significant level of hyperphosphatemia in adults is >6 mg/dL.

Monitoring

Monitoring of Hyperphosphatemia in Chronic Kidney Disease (CKD) Patients
  • Monitoring of serum phosphate in CKD patients should start in patients with grade 3 CKD
    • Frequency of monitoring will be based on the presence and magnitude of abnormalities and the rate of progression of the disease
  • Monitoring of serum phosphate intervals may be as followed:
    • Every 6-12 months in patients with grade 3 CKD
    • Every 3-6 months in patients with grade 4 CKD
    • Every 1-3 months in patients with grade 5 CKD
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