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hyperfosfatemie

Hyperphosphatemia, also known as hyperfosfatemie, is a condition characterized by an elevated level of phosphate in the blood. In adults, it is generally defined as a serum phosphate concentration above about 1.5 mmol/L (approximately 4.5 mg/dL). It is most commonly seen in chronic kidney disease and end-stage kidney failure, where renal excretion of phosphate is impaired. Other causes include excessive phosphate intake, rapid cell breakdown (such as tumor lysis syndrome or rhabdomyolysis), vitamin D intoxication, hypoparathyroidism, and certain medications or conditions that reduce phosphate clearance or promote shifts of phosphate into the extracellular space.

Pathophysiology typically involves an imbalance between phosphate intake, cellular distribution, and renal excretion. In kidney disease,

Clinical features are often absent until phosphate levels are markedly elevated or complications arise. Symptoms may

Management focuses on treating the underlying cause, restricting dietary phosphate intake, and using phosphate binders (calcium-based

reduced
filtration
leads
to
phosphate
accumulation.
The
excess
phosphate
can
bind
calcium,
contributing
to
hypocalcemia
and
secondary
hyperparathyroidism.
Regulators
such
as
fibroblast
growth
factor
23
(FGF23)
and
parathyroid
hormone
(PTH)
adjust
intestinal
absorption
and
renal
handling
of
phosphate,
but
their
effects
are
limited
when
kidney
function
is
impaired.
Chronic
hyperphosphatemia
is
linked
to
vascular
and
soft
tissue
calcification,
contributing
to
cardiovascular
risk
and
bone-mineral
disorders
in
kidney
disease.
relate
to
hypocalcemia
(tingling,
cramps)
or
to
calcifications
in
vessels
and
soft
tissues.
Diagnosis
relies
on
measuring
serum
phosphate
and
assessing
related
parameters
such
as
calcium,
PTH,
vitamin
D,
and
kidney
function,
along
with
evaluation
for
underlying
causes.
or
non-calcium-based)
with
meals.
In
dialysis-dependent
patients,
optimization
of
dialysis
and
adjustment
of
vitamin
D
analogs
and
PTH-directed
therapies
are
common.
Severe
hyperphosphatemia
or
calciphylaxis
may
require
more
aggressive
interventions.
Prognosis
is
closely
tied
to
the
presence
and
severity
of
kidney
disease
and
associated
vascular
calcification.