From the Guidelines
Hyperphosphatemia is primarily caused by high phosphate intake, kidney dysfunction, and certain metabolic disorders.
Causes of Hyperphosphatemia
- High phosphate intake: Excessive consumption of phosphate-rich foods, such as processed foods, animal products, and certain vegetables, can lead to hyperphosphatemia 1.
- Kidney dysfunction: Impaired kidney function, particularly in patients with chronic kidney disease (CKD), can result in decreased phosphate excretion and subsequent hyperphosphatemia 1.
- Vitamin D deficiency: Vitamin D deficiency can contribute to hyperphosphatemia by increasing parathyroid hormone (PTH) levels, which can lead to increased phosphate release from bones 1.
- Hypocalcemia: Low calcium levels can stimulate PTH release, leading to increased phosphate mobilization from bones and hyperphosphatemia 1.
- Dialysate phosphate supplementation: In patients undergoing hemodialysis, phosphate supplementation in the dialysate can lead to hyperphosphatemia if not properly monitored 1. The pathogenesis of hyperphosphatemia is complex and multifactorial, involving various physiological and pathological processes. Restricting dietary phosphate intake is a crucial aspect of managing hyperphosphatemia, particularly in patients with CKD 1.
From the Research
Causes of Hyperphosphatemia
The causes of hyperphosphatemia can be categorized into three broad groups:
- Decreased glomerular filtration rate 2
- Increased exogenous or endogenous phosphate load 2, 3
- Increased renal tubular phosphate reabsorption 2
Specific Causes
Some specific causes of hyperphosphatemia include:
- Kidney failure 3, 4, 5, 6
- Use of phosphate-containing enemas 3
- Rhabdomyolysis 3
- Tumor lysis syndrome 3
- Massive acute phosphate load 4
- Primary increase in renal phosphate reabsorption 4
- Impaired renal phosphate excretion due to acute or chronic renal insufficiency 4
Associated Conditions
Hyperphosphatemia is often associated with other conditions, such as: