Hypophosphatemia Questions & Answers

Updated: Dec 12, 2019
  • Author: Eleanor Lederer, MD, FASN; Chief Editor: Vecihi Batuman, MD, FASN  more...
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Questions & Answers

Overview

How is hypophosphatemia defined?

Where does phosphate reside in the body?

What is the role of sodium phosphate transport proteins in the pathophysiology of hypophosphatemia?

Which factors cause variation in the concentration of serum phosphate?

How is serum phosphate concentration regulated?

How much phosphate is provided in a normal diet?

What is the mechanism for regulation of intestinal phosphate transport?

How can the absorption of phosphate be blocked in hypophosphatemia?

Which factors influence bone metabolism of phosphate?

What is the role of the kidneys in phosphate homeostasis?

What is the role of genetics in phosphate homeostasis?

What is the role of fibroblast growth factor 23 (FGF23) in phosphate homeostasis?

Which pathogenic mechanisms cause hypophosphatemia?

What is the role of inadequate phosphate intake in the pathophysiology of hypophosphatemia?

What is the role of increased phosphate excretion in the pathophysiology of hypophosphatemia?

How does a shift of phosphate from extracellular to intracellular space cause hypophosphatemia?

What is the prevalence of hypophosphatemia in the US?

What is the mortality and morbidity associated with hypophosphatemia?

How does the incidence of hypophosphatemia vary by sex and race?

How does the prevalence of hypophosphatemia vary by age?

Presentation

What are the signs and symptoms of hypophosphatemia?

Which clinical history is characteristic of mild hypophosphatemia?

Which clinical history is characteristic of moderate hypophosphatemia?

What are the signs and symptoms of hypophosphatemia in chronic phosphate wasting syndromes?

What should be the focus of history in the evaluation of suspected hypophosphatemia?

What are the physical signs of hypophosphatemia?

Which genetic disorders cause phosphate wasting?

What patient populations are at risk for hypophosphatemia due to inadequate phosphate intake?

What causes phosphate wasting in hypophosphatemia?

What is the role of genetics in the etiology of hypophosphatemia?

What are the possible etiologies of acquired wasting syndromes causing hypophosphatemia?

What is the role of intracellular shifts of phosphate in the etiology of hypophosphatemia?

Which pathogenic mechanisms cause an intracellular shift of phosphate?

What causes hypophosphatemia in kidney transplantation?

DDX

Which conditions should be included in the differential diagnoses of hypophosphatemia?

Which clinical features should be considered in the differential diagnosis of hypophosphatemia?

What are the differential diagnoses for Hypophosphatemia?

Workup

What is the role of lab studies in the workup of hypophosphatemia?

What is the role of serum albumin measurement in the workup of hypophosphatemia?

How are parathyroid hormone (PTH) and vitamin D disorders differentiated from hypophosphatemia?

Which lab studies are indicated in the workup of hypophosphatemia in select patients?

How is phosphate wasting assessed the workup for hypophosphatemia?

What is the role of imaging studies in the workup of hypophosphatemia?

Which histologic findings are characteristic of hypophosphatemia?

What is the role of bone biopsy in the evaluation of hypophosphatemia?

Treatment

What is basis for medical care for hypophosphatemia?

What is the focus of treatment for hypophosphatemia?

What is the role of oral phosphate supplements in the treatment of hypophosphatemia?

What is the role of parenteral phosphate supplementation in the treatment of hypophosphatemia?

How does the treatment of hypophosphatemia vary based on severity?

What is the role of vitamin D supplementation in the treatment of hypophosphatemia?

What is fibroblast growth factor 23 (FGF23) antibody treatment for hypophosphatemia?

What is the role of surgery in the treatment of hypophosphatemia?

Which specialist consultations are beneficial in the treatment of hypophosphatemia?

Which dietary modifications are used in the treatment of hypophosphatemia?

Which activity modifications are indicated during treatment of hypophosphatemia?

Medications

What are the goals of drug treatment for hypophosphatemia?

Which medications in the drug class Monoclonal Antibodies, Endocrine are used in the treatment of Hypophosphatemia?

Which medications in the drug class Calcimimetic drugs are used in the treatment of Hypophosphatemia?

Which medications in the drug class Vitamin D preparations are used in the treatment of Hypophosphatemia?

Which medications in the drug class Mineral supplements are used in the treatment of Hypophosphatemia?

Follow-up

What is included in long-term monitoring following treatment of hypophosphatemia?

How is a transient reversible episode of hypophosphatemia distinguished from a chronic condition?

How is hypophosphatemia with a vitamin D deficiency managed?

How is hypophosphatemia due to eating disorders or congenital wasting disorders managed?

How are acquired phosphate wasting syndromes managed?

Which supplements are indicated in the treatment of hypophosphatemia?

When is transfer indicated in patients with hypophosphatemia?

How is hypophosphatemia prevented?

What are the possible complications of hypophosphatemia?

What is the prognosis of hypophosphatemia?

What is included in patient education for hypophosphatemia?