Workup for Hyperphosphatemia - Differential Diagnosis Framework

Rule out spurious hyperphosphatemia: paraproteinemia, hyperlipidemia, hemolysis, hyperbilirubinemia, liposomal amphotericin B, t-PA, heparin

Acute Phosphate Load:

 • Exogenous: Excessive phosphate intake, Phosphate laxatives, Vitamin D toxicity, Fosphenytoin

 • Endogenous: Rhabdomyolysis, Tumor lysis syndrome, Hemolysis

Transcellular Shift:

 • Lactic acidosis, DKA

Kidney Disease:

 • AKI, CKD

Increased Renal Phosphate Absorption: 

 • Hypoparathyroidism, Acromegaly, FGFR inhibitors, Familial tumoral calcinosis, Bisphosphonates



Dr. Aisha Shaikh @aishaikh



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