199 results
Workup for Hyperphosphatemia - Differential Diagnosis Framework
Rule out spurious hyperphosphatemia: paraproteinemia, hyperlipidemia, hemolysis, hyperbilirubinemia, liposomal amphotericin
heparin Acute Phosphate ... Exogenous: Excessive phosphate ... intake, Phosphate ... Increased Renal Phosphate ... Absorption:
High plasma phosphate level
Plasma Ca?+ level drops
Kidneys
Reduction of
25-(OH) D hydroxy-lase activity
Increased PTH secretion
Parathyroid
Increased phosphate exeretion
Skeleton
Reduced phosphate
High plasma phosphate ... Parathyroid Increased phosphate ... Skeleton Reduced phosphate ... mobilization Plasma phosphate ... absorption
Hypophosphatemia - Differential Diagnosis Algorithm
 • Decreased intake/absorption: Starvation, Alcoholism, Malabsorption, Phosphate binder use
 • Redistribution/
Decreased intake/absorption ... Malabsorption, Phosphate ... causes #nephrology #phosphate
Hyperphosphatemia - Differential Diagnosis Algorithm
Transcellular Shift:
 • Rhabdomyolysis
 • Tumor Lysis
 • Metabolic or Respiratory Acidosis
Increased Intake / Absorption ... Hypervitaminosis D • Phosphate ... Supplementation • Phosphate
Hypophosphatemia - Differential Diagnosis Algorithm
Appropriately Low Kidney Phosphate Excretion:
 • Decreased GI Absorption: Chronic Diarrhea, Antacids,
Appropriately Low Kidney Phosphate ... • Decreased GI Absorption ... Diarrhea, Antacids, Phosphate ... Inappropriately High Kidney Phosphate
Characteristics of Commonly Used Phosphate Binders 
Aluminum 
 - Potent and effective 
 - Useful for
Commonly Used Phosphate ... - No systemic absorption ... - Significant absorption ... significant systemic absorption ... amzn.to/34t5DgJ #Phosphate
Total-Body Deficits in Chronic Alcohol-Use Disorder. Patients with chronic alcohol-use disorder may have total-body deficits of
total-body deficits of phosphate ... gastrointestinal absorption
Hydroxychloroquine and Chloroquine in COVID19

Dosing:
Hydroxychloroquine:
 - 400mg PO BID on the first day, followed by 200mg
if concerns for absorption ... 500mg Chloroquine phosphate
Workup for Hypophosphatemia - Differential Diagnosis Framework
Rule out spurious hypophosphatemia: paraproteinemia, acute leukemia
Measure Urine Fractional Excretion
Fractional Excretion of Phosphate ... diarrhea, Poor absorption ... Framework #Workup #phosphate
Phosphate Binders - Pros and Cons

Calcium carbonate (TumsTM) 
 - Most inexpensive, antacid properties useful for
Phosphate Binders ... less GI calcium absorption ... amzn.to/34t5DgJ #Phosphate