September 24, 2017
Hyperphosphataemia Minimize

Hyperphosphataemia

Renal failure is the commonest cause of hyperphosphataemia in clinical practise.

Spurious elevations in phosphate occur with paraproteinaemia, hyperlipidaemia, haemolysis and hyperbilirubinaemia and these should be considered in unexplained hyperphosphataemia.

Hyperphosphataemia is common in lactic acidosis and may reflect loss of intracellular phosphate following hydrolysis of ATP.

Hyperphosphatemia occurs in patients receiving phosphate enemas.

Rapid elevations in phosphate may result in hypocalcaemia and precipitation of calcium phosphate crystals (metastatic calcification). Although hypocalcaemia is the usual response to raised phosphate if the cause is bone breakdown, then elevations in both calcium and phosphate will ensue.

Symptoms and signs of hyperphosphataemia

Heart

conduction disturbances, heart failure

Kidneys

oliguria

GI tract

anorexia, nausea, vomiting, ileus, GI bleeding

Lungs

breathlessness, reduced O2 diffusion

Eyes

conjunctival inflammation

Skin

papules, digital ischaemia

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Reference

  • Weisinger JR, Bellorin-Font E. Magnesium and phosphorus. Lancet 1998;352:391-396.
  

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