Hyperphosphataemia
CAUSES
- renal failure
- increased renal resorption (hypoparathyroidism, thyrotoxicosis)
- cellular injury with release (tumour lysis syndrome, rhabdomyolysis, haemolysis, ischemic gut)
- medication related: phosphate containing laxatives, excessive administration, bisphosphonate therapy
CLINICAL FEATURES (related to hypocalcaemia)
- precipitation of Ca2+ (nephrolithiasis)
- interference with parathyroid hormone-mediated resorption of bone
- decreased vitamin D levels
- muscle cramping
- tetany
- hyperreflexia
- seizures
- cardiovascular manifestations (prolonged QT)
MANAGEMENT
- treat underlying condition
- limit phosphate intake
- enhance urinary phosphate excretion (saline, acetazolamide)
- dialysis
- oral phosphate binders (calcium and aluminium salts)
References and Links
- CCC – Hyperphosphataemia
- CCC – Hyperphosphataemia Mind Map (PDF)
- CCC – Hypophosphataemia
- CCC – Hypophosphataemia Mind Map (PDF)
Critical Care
Compendium
Chris is an Intensivist and ECMO specialist at The Alfred ICU, where he is Deputy Director (Education). He is a Clinical Adjunct Associate Professor at Monash University, the Lead for the Clinician Educator Incubator programme, and a CICM First Part Examiner.
He is an internationally recognised Clinician Educator with a passion for helping clinicians learn and for improving the clinical performance of individuals and collectives. He was one of the founders of the FOAM movement (Free Open-Access Medical education) has been recognised for his contributions to education with awards from ANZICS, ANZAHPE, and ACEM.
His one great achievement is being the father of three amazing children.
On Bluesky, he is @precordialthump.bsky.social and on the site that Elon has screwed up, he is @precordialthump.
| INTENSIVE | RAGE | Resuscitology | SMACC