Hypophosphatemia - Differential Diagnosis Algorithm



Transcellular Shift

 • Recovery From DKA

 • Refeeding Syndrome

 • Acute Respiratory Alkalosis

 • Hypokalemia

 • Hypomagnesemia

 • Burns



Increased Excretion - GI:

 • Small bowel diarrhea

 • Enteric Fistula

Increased Excretion - Renal FE PO4 > 5%:

 • Hyperparathyroidism

 • Vitamin D Deficiency/Resistance

 • Hypophosphatemic Rickets

 • Oncogenic Osteomalacia

 • Fanconi Syndrome

 • Osmotic Diuresis

 • Acute Volume Expansion

 • Acetazolamide and Thiazide Diuretics

Decreased Intake - Dietary deficiency:

 • Anorexia

 • Chronic Alcoholism

Decreased Intake - Malabsorption:

 • Aluminum/Magnesium Containing Antacids

 • Inflammatory Bowel Disease

 • Steatorrhea

 • Chronic Diarrhea



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