1. 1278
Hyperphosphatemia
HYPERPHOSPHATEMIA ICD-9CM # ​
995.5 ​
Child Maltreatment Syndrome
Rhabdomyolysis
Cell destruction
Hyperpyrexia
Hemolysis
Leukemia
Neoplastic
CPK Ͼ110 mg/dl Lymphoma
Tumor lysis syndrome
LDH Ͼ220 mg/dl
UA Ͼ7.5 mg/dl
Increased Check
phosphorus load LDH, Cutaneous White phosphorus burns
UA,
CPK Transfusion of stored blood
Parenteral
Intravenous PO4 Replacement therapy
PO4-containing laxatives or enemas
Enteral PO4 intake
Etidronate disodium
Vit D intoxication
Respiratory acidosis
Anion gap 8-13
Check
Acidosis anion
gap
HCOϪ Ͻ22 mEq/L
3
UPO4 Ͼ1500 mg/day Anion gap Ͼ13
Check Lactic acidosis
Redistribution of phosphorus Diabetic ketoacidosis
HCOϪ3
Tissue ischemia
HCOϪ Ͼ22 mEq/L
3
Hyperphosphatemia Check
(SPO4 Ͼ5.2 mg/dl) UPO4 Cortical hyperostosis
Miscellaneous causes
Familial hyperphosphatemia
Acute renal failure
UPO4 Ͻ1500 mg/day Decreased filtration Hypoparathyroidism
Chronic renal failure
CrCI Ͻ25 ml/min PTH Ͻ29 pmol/L
Decreased Measure Check
PO4 excretion CrCI Ca
Ca Ͻ8.5 mg/dl
CrCI Ͼ25 ml/min PTH 29-81 pmol/L
Pseudohypoparathyroidism
Decreased tubular Check Abnormal PTH
clearance Ca Multiple myeloma
Hyperthyroidism
Ca 8.5-10.4 mg/dl Hormonal Acromegaly
Postmenopausal
Volume contraction
FIGURE 3-166 ​ pproach to hyperphosphatemia. CT, Computed tomography; MRI, magnetic resonance imaging; T,
A Mg deficiency
Nonhormonal
thyroxine; TSH, thyroid-stimulating hormone. (From Healey PM: Common medical diagnosis: an algorithmic approach, ed Hyperthermia
3, Philadelphia, 2000, WB Saunders.) Tumor calcinosis