Merck Manual

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Hyperphosphatemia (High Level of Phosphate in the Blood)

By

James L. Lewis III

, MD, Brookwood Baptist Health and Saint Vincent’s Ascension Health, Birmingham

Reviewed/Revised Sep 2021 | Modified Sep 2022
VIEW PROFESSIONAL VERSION

In hyperphosphatemia, the level of phosphate in blood is too high.

Less commonly, hyperphosphatemia develops in people with the following:

Symptoms of Hyperphosphatemia

Most people with hyperphosphatemia do not have symptoms. However, in people with severe kidney dysfunction, calcium combines with phosphate, which lowers calcium levels in the blood (a disorder called hypocalcemia) Hypocalcemia (Low Level of Calcium in the Blood) In hypocalcemia, the calcium level in blood is too low. A low calcium level may result from a problem with the parathyroid glands, as well as from diet, kidney disorders, or certain drugs. As... read more . Low calcium can cause muscle cramps and spasms but also causes an increase in parathyroid hormone levels, resulting in bone weakness and other problems.

The calcium and phosphate also can form crystals (calcify) in body tissue, including within the walls of the blood vessels. Severe arteriosclerosis Atherosclerosis Atherosclerosis is a condition in which patchy deposits of fatty material (atheromas or atherosclerotic plaques) develop in the walls of medium-sized and large arteries, leading to reduced or... read more Atherosclerosis (hardening of the arteries) can result, leading to strokes, heart attacks, and poor circulation.

Crystals can also form in the skin, where they cause severe itching.

Diagnosis of Hyperphosphatemia

  • Measurement of phosphate levels in the blood

The diagnosis of hyperphosphatemia is based on blood tests indicating that the phosphate level is high.

Treatment of Hyperphosphatemia

  • A diet low in phosphate

  • Drugs to increase phosphate excretion

In people with kidney dysfunction, hyperphosphatemia is treated by reducing consumption of phosphate and reducing absorption of phosphate from the digestive tract. Foods that are high in phosphate, such as milk, egg yolks, chocolate, and soft drinks, should be avoided.

Drugs that bind with phosphate, such as sevelamer, lanthanum, and calcium compounds, should be taken with meals as prescribed by a doctor. These drugs make phosphate harder to absorb, and more phosphate is excreted. Sevelamer and lanthanum are often used for people undergoing dialysis because calcium compounds can make calcium-phosphate crystals more likely to form in tissues.

Drugs Mentioned In This Article

Generic Name Select Brand Names
NATPARA
RenaGel, Renvela
NOTE: This is the Consumer Version. DOCTORS: VIEW PROFESSIONAL VERSION
VIEW PROFESSIONAL VERSION
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