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
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Heart
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conduction disturbances, heart failure
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Kidneys
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oliguria
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GI tract
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anorexia, nausea, vomiting, ileus, GI bleeding
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Lungs
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breathlessness, reduced O2 diffusion
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Eyes
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conjunctival inflammation
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Skin
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papules, digital ischaemia
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Reference