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For further information, see CMDT Part 21-11: Hyperphosphatemia
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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
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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