Definition: Phosphate (Phos) > 4.5 mg/dL

Causes

• Renal Failure – Most Common Cause
• Tumor Lysis Syndrome
• Rhabdomyolysis
• Hypoparathyroidism
• Bisphosphonates
• Lactic Acidosis with Acute Extracellular Shift of Phosphate
• Exogenous Administration
• Sodium Phosphate (Fleet) Enemas in Renal Failure

Presentation

• Most are Asymptomatic
• Tetany
• Soft-Tissue Calcifications

Treatment

• Acute Severe Elevations: Normal Saline (NS) Infusion and Diuresis
  • May Also Require Hemodialysis
• Mild or Chronic Elevations: Low Phosphate Diet and Phosphate Binders
  • Phosphate Binders:
    • Calcium Carbonate (Tums)
    • Calcium Acetate (Phoslo)
    • Sevelamer