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Hypophosphatemia

Summary

Hypophosphatemia is defined as a serum phosphate of < 2.5 mg/dL. It is more common in patients with alcohol use disorder and in critically unwell patients, who have high phosphate demands. Particularly in mild deficiency, symptoms can be nonspecific or absent entirely. However, severe hypophosphatemia can cause serious complications such as seizures, respiratory failure, and arrhythmias. Treatment may be oral or intravenous, depending on the severity of the deficiency, and should occur in conjunction with investigation of underlying causes. Supplementation regimens are covered in electrolyte repletion.

Definition

  • Serum phosphate of < 2.5 mg/dL [1]
  • Severe hypophopshatemia occurs at < 1 mg/dL. [1]

Etiology

Mechanism

Cause [2][3][4]

Increased renal excretion

Insufficient intestinal absorption

Transcellular phosphate shifts

Extreme catabolic states

Pseudohypophosphatemia

Clinical features

Although mild hypophosphatemia rarely causes symptoms, moderate to severe hypophosphatemia is associated with various cardiac, musculoskeletal, neurological, and hematological abnormalities. [3][4]

Treatment

Complications

We list the most important complications. The selection is not exhaustive.

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last updated 09/22/2020
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