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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:
Hypophosphatemia - Differential Diagnosis Algorithm • Decreased intake/absorption: Starvation, Alcoholism, Malabsorption, Phosphate binder use • Redistribution/
Decreased intake/absorption ... Malabsorption, Phosphate ... causes #nephrology #phosphate
Major Segments of the Nephron and their Functions - Glomerulus - Formation of glomerular filtrate
tubule (PCT) - Reabsorption ... Isosmotic reabsorption ... Secretion and reabsorption ... loop - Passive reabsorption ... Pathophysiology #Tubules #Table
Phosphate binders - quick reference chart of maximum daily dose. Most patients with CKD will require
Phosphate binders ... CKD will require phosphate ... since they are not able ... based on serum phosphate ... aluminum-based phosphate
Hyperphosphatemia - Differential Diagnosis Algorithm Transcellular Shift: • Rhabdomyolysis • Tumor Lysis • Metabolic or Respiratory Acidosis
Increased Intake / Absorption ... Hypervitaminosis D • Phosphate ... Supplementation • Phosphate
Characteristics of Commonly Used Phosphate Binders Aluminum - Potent and effective - Useful for
Commonly Used Phosphate ... - No systemic absorption ... - Significant absorption ... amzn.to/34t5DgJ #Phosphate ... #Binders #Table
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
Phosphate Binders - Pros and Cons Calcium carbonate (TumsTM) - Most inexpensive, antacid properties useful for
Phosphate Binders ... less GI calcium absorption ... amzn.to/34t5DgJ #Phosphate ... #Binders #Table
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
Urine Microscopy Crystals Uric Acid crystals: - Formation promoted by acidic urine - Seen in tumor lysis
syndrome Calcium phosphate ... Magnesium ammonium phosphate ... struvite or "triple phosphate ... Crystals #comparison #table
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