Hyperphosphatemia

Hyperphosphatemia is an electrolyte disorder characterized by elevated phosphate levels in the blood, typically defined as serum phosphate exceeding 5 mg/dL (1.6 mmol/L) in adults. It arises from increased phosphate intake, reduced renal excretion, or pathological shifts of intracellular phosphate into the extracellular space. Common causes include chronic kidney disease, especially end-stage renal disease (ESRD), where prevalence ranges from 50% to 74%, and conditions such as hypoparathyroidism, pseudohypoparathyroidism, diabetic ketoacidosis, and certain oncologic treatments like liposomal amphotericin. While many patients are asymptomatic, complications may include soft tissue calcification, joint calcification, and muscle spasms due to secondary hypocalcemia. Genetic mutations in FGF23, GALNT3, or KL can also contribute to the disorder. Management involves dietary phosphate restriction, phosphate-binding medications, and dialysis in severe cases.