endocrine and metabolic disorders
Hypophosphatemia
Etiology of Hypophosphatemia
Hypophosphatemia has numerous causes. Clinically significantacute hypophosphatemiaoccurs in relatively few clinical settings, including the following: The recovery phase of Diabetic Ketoacidosis (DKA) None Acute Alcohol Use Disorder and Rehabilitation None Severe Burns None When receiving Total Parenteral Nutrition (TPN) None Refeeding after prolonged Overview of Undernutrition None Severe Respiratory Alkalosis None Acute severe hypophosphatemia with serum phosphate < 1 mg/dL (< 0.32 mmol/L) is most often caused by Transcellular shifts of phosphate often superimposed on chronic phosphate depletion Chronic hypophosphatemiausually is the result of decreased renal phosphate reabsorption. Causes include the following: levels, as in primary and secondary Hyperparathyroidism None Other hormonal disturbances, such as Cushing Syndrome and Vitamin D Deficiency and Dependency None Electrolyte disorders, such as Hypomagnesemia and Long-term diuretic use Theophyllineintoxication Severe chronic hypophosphatemia usually results from a prolonged negative phosphate balance. Causes include Chronic starvation or malabsorption, often in patients with alcohol use disorder, especially when combined with vomiting or copious diarrhea Long-term ingestion of large amounts of phosphate-binding aluminum, usually in the form of antacids Patients with advanced Chronic Kidney Disease (especially those on dialysis) often take phosphate binders with meals to reduce absorption of dietary phosphate. The prolonged use of these binders can cause hypophosphatemia, particularly when combined with greatly decreased dietary intake of phosphate. 