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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.

Hypophosphatemia & Hyperphosphatemia References

  1. DiMeglio LA, White KE, Econs MJ. Disorders of phosphate metabolism. Endocrinol Metab Clin North Am. 2000 Sep;29(3):591-609. PMID: 11033762
  2. MedWormhttp://www.medworm.com/rss/index.php/Pediatrics/33/http://www.medworm.com/rss/medicalfeeds/specialities/Pediatrics.xml
  3. Arnold JL, Bibb J. Hypophosphatemia. http://www.emedicine.com/emerg/topic278.htm. 2006.
  4. Berkoben M, Quarles LD. Management of hyperphosphatemia in chronic kidney disease. UpToDate. www.uptodate.com. Dec 2017.
  5. Bringhurst FR, Demay MB, Kronenberg HM. Hormones and disorders of mineral metabolism. In: Kronenberg HM, Melmed S, Polonsky KS, Larsen PR, ed. William's Textbook of Endocrinology. 13th ed. Philadelphia, PA: Elsevier Inc; 2016. 1304-1307. :1304-1307.
  6. Kidney Disease: Improving Global Outcomes (KDIGO) CKD-MBD update work group. KDIGO 2017 clinical practice guideline update for the diagnosis, evaluation, prevention, and treatment of chronic kidney disease–mineral and bone disorder (CKD-MBD). Kidney Int Suppl. 2017;7:S1-S59.
  7. Kidney Disease: Improving Global Outcomes (KDIGO) CKD-MBD work group. KDIGO clinical practice guideline for the diagnosis, evaluation, prevention, and treatment of Chronic Kidney Disease-Mineral and Bone Disorder (CKD-MBD). Kidney Int Suppl. 2009 Aug;113:S1-S59. doi: 10.1038/ki.2009.188. PMID: 19644521
  8. Moe SM, Kulkarni DP. Disorders of calcium, phosphorus and magnesium homeostasis. In: Gilbert SJ, Weiner DE, ed. National Kidney Foundation’s Primer on Kidney Diseases. 7th ed. Philadelphia, PA: Elsevier Inc; 2018. 116. :116.
  9. National Institute for Health and Clinical Excellence. Hyperphosphatemia in chronic kidney disease: management of hyperphosphatemia in patients with stage 4 or 5 chronic kidney disease. NICE. www.nice.org.co.uk. Mar 2013.
  10. Stubbs JR, Yu ASL. Overview of the causes and treatment of hyperphosphatemia. UpToDate. www.uptodate.com. Nov 2017.
  11. Voinescu A. Hyperphosphatemia. First Consult. https://www.clinicalkey.com. Jan 2014.
  12. Yu ASL. Disorders of magnesium and phosphorus. In: Goldman L, Schaer AI . Goldman-Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Inc; 2016.
  13. Yu ASL, Stubbs JR. Evaluation and treatment of hypophosphatemia. UpToDate. www.uptodate.com. Jul 2017.
  14. Yu ASL, Stubbs JR. Signs and symptoms of hypophosphatemia. UpToDate. www.uptodate.com. Dec 2017.
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