hypophosphatemia%20-and-%20hyperphosphatemia
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.

  1. Weisinger JR, Bellorin-Font E. Electrolyte quintet: magnesium and phosphorus. Lancet. 1998 Aug;352(9125):391-396. PMID: 9717944
  2. DiMeglio LA, White KE, Econs MJ. Disorders of phosphate metabolism. Endocrinol Metab Clin North Am. 2000 Sep;29(3):591-609. PMID: 11033762
  3. Miller DW, Slovis CM. Hypophosphatemia in the emergency department therapeutics. Am J Emerg Med. 2000 Jul;18(4):457-461. PMID: 10919539
  4. Kapoor M, Chan GZ. Fluid and electrolyte abnormalities. Crit Care Clin. 2001 Jul;17(3):503-529. PMID: 11525047
  5. Diseases of the parathyroid gland and other hyper- and hypocalcemic disorders. Harrison's Online: McGraw-Hill Companies; 2003.
  6. Introduction to bone and mineral metabolism. Harrison's Online: McGraw-Hill Companies; 2003.
  7. Larsen. Disorders of phosphate metabolism. Hyperphoshatemia. In: Kronenberg HM, Melmed S, Polonsky KS, Larsen PR, eds. William's Textbook of Endocrinology. 10th. Philadelphia: Saunders, an imprint of Elsevier; 2003.
  8. MedWormhttp://www.medworm.com/rss/index.php/Pediatrics/33/http://www.medworm.com/rss/medicalfeeds/specialities/Pediatrics.xml
  9. Arnold JL, Bibb J. Hypophosphatemia. http://www.emedicine.com/emerg/topic278.htm. 2006.
  10. Patterson LA, et al. Hypophosphatemia. http://www.emedicine.com/emerg/topic266.htm. 2006.
  11. Berkoben M, Quarles LD. Management of hyperphosphatemia in chronic kidney disease. UpToDate. www.uptodate.com. Dec 2017.
  12. 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.
  13. 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.
  14. 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
  15. 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.
  16. 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.
  17. Stubbs JR, Yu ASL. Overview of the causes and treatment of hyperphosphatemia. UpToDate. www.uptodate.com. Nov 2017.
  18. Voinescu A. Hyperphosphatemia. First Consult. https://www.clinicalkey.com. Jan 2014.
  19. Yu ASL. Disorders of magnesium and phosphorus. In: Goldman L, Schaer AI . Goldman-Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Inc; 2016.
  20. Yu ASL, Stubbs JR. Evaluation and treatment of hypophosphatemia. UpToDate. www.uptodate.com. Jul 2017.
  21. Yu ASL, Stubbs JR. Signs and symptoms of hypophosphatemia. UpToDate. www.uptodate.com. Dec 2017.
Digital Edition
Asia's trusted medical magazine for healthcare professionals. Get your MIMS Endocrinology - Malaysia digital copy today!
Sign In To Download
Editor's Recommendations
Most Read Articles
Pearl Toh, 6 days ago
Impaired endothelial-dependent microvascular reactivity appears to be predictive of albuminuria progression in Asian patients with type 2 diabetes (T2D) who have normal urine albumin levels at baseline, but not in those with microalbuminuria, a prospective longitudinal cohort study suggests.
Stephen Padilla, 6 days ago
The use of dipeptidyl peptidase-4 inhibitors may heighten the risk of inflammatory bowel disease (IBD) in patients with type 2 diabetes (T2D), according to a recent study.