Phosphate disorders and clinical management of hypophosphatemia and hyperphosphatemia

Endocrinol Diabetes Nutr (Engl Ed). 2020 Mar;67(3):205-215. doi: 10.1016/j.endinu.2019.06.004. Epub 2019 Sep 26.
[Article in English, Spanish]

Abstract

Serum phosphorus levels range from 2.5 and 4.5mg/dL (0.81-1.45 mmol/L) in adults, with higher levels in childhood, adolescence, and pregnancy. Intracellular phosphate is involved in intermediary metabolism and other essential cell functions, while extracellular phosphate is essential for bone matrix mineralization. Plasma phosphorus levels are maintained within a narrow range by regulation of intestinal absorption, redistribution, and renal tubular absorption of the mineral. Hypophosphatemia and hyperphosphatemia are common clinical situations, although changes are most often mild and oligosymptomatic. However, acute and severe conditions that require specific treatment may occur. In this document, members of the Mineral and Bone Metabolism Working Group of the Spanish Society of Endocrinology and Nutrition review phosphate disorders and provide algorithms for adequate clinical management of hypophosphatemia and hyperphosphatemia.

Keywords: Fósforo sérico; Hiperfosfatemia; Hipofosfatemia; Hyperphosphatemia; Hypophosphatemia; Serum phosphorus.

MeSH terms

  • Decision Trees
  • Homeostasis
  • Humans
  • Hyperphosphatemia / diagnosis*
  • Hyperphosphatemia / therapy*
  • Hypophosphatemia / diagnosis*
  • Hypophosphatemia / therapy*
  • Phosphates / physiology

Substances

  • Phosphates