Sections View Full Chapter Figures Tables Videos Annotate Full Chapter Figures Tables Videos Supplementary Content + Download Section PDF Listen ++ For further information, see CMDT Part 21-11: Hyperphosphatemia + Key Features Download Section PDF Listen +++ ++ Advanced CKD is the most common cause Hyperphosphatemia in the presence of hypercalcemia imposes a high risk of metastatic calcification Main cause is advanced chronic kidney disease (CKD) with insufficient urinary excretion of phosphorus Hyperphosphatemia in the presence of hypercalcemia imposes a high risk of metastatic calcification + Clinical Findings Download Section PDF Listen +++ ++ Symptoms are those of the underlying disorders (eg, CKD, hypoparathyroidism) + Diagnosis Download Section PDF Listen +++ ++ Elevated phosphate levels Blood chemistry abnormalities are those of the underlying disease + Treatment Download Section PDF Listen +++ ++ Treatment is directed at the underlying disorder Exogenous sources of phosphate, including enteral or parenteral nutrition and medications, should be reduced or eliminated In acute kidney injury and CKD, dialysis will reduce serum phosphate Dietary phosphate absorption can be reduced by oral phosphate binders, such as Calcium carbonate Calcium acetate Sevelamer carbonate Lanthanum carbonate Aluminum hydroxide Sevelamer, lanthanum, and aluminum may be used in patients with concomitant hypercalcemia, although aluminum use should be limited to a few days because of the risk of aluminum accumulation and neurotoxicity