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phosphate balance (hypophosphatemia (intracellular shift (hormonal effects…
phosphate balance
hypophosphatemia
intracellular shift
carbohydrate infusions
hormonal effects
catechols
insulin
respiratory alkalosis
rapid cellular proliferation
leukemic blast crisis
hungry bone syndrome
decreased phosphate absorption
dietary
PO4
deprivation
(hard to achieve)
malabsorption
(low PO4 usually due to renal losses in setting of GI malabsorption of calcium and vit D - secondary hyperparathyroidism)
phosphate binding
antacids
vitamin D deficiency
(although predominant cause of low PO4 in this setting is renal due to secondary hyperparathyroidism due to calcium deficiency)
increased renal phosphate excretion
hyperparathyroidism (primary or secondary)
oncogenic osteomalacia
developed renal phosphate wasting (benign tumor hidden, making FGF-23)
genetic defects in phosphate metabolism
ADHR
- decreased metabolism of FGF23 (mutation in FGF23), resistant to breakdown
X-linked phosphatemic rickets
- decreased metabolism of FGF23 (mutation in
PHEX
)
alcoholism
lowers phosphate content of cells via ethanol
hyperphosphatemia
massive phosphate load
tumor lysis syndrome
rhabdomyolysis
exogenous phosphate administration
laxatives
renal failure
increased tubular reabsorption
hypoparathyroidism
tumoral calcinosis (very low FGF-23!)