hyperphosphatemia

1278 U PO 4 1500 mg/day U PO 4 1500 mg/day Decreased PO 4 excretion Hyperphosphatemia (S PO 4 5.2 mg/dl) Check U PO 4 Measure CrCI CrCI 25 ml/min CrCI 25 ml/min Ca 8.5 mg/dl Ca 8.5-10.4 mg/dl PTH 29 pmol/L PTH 29-81 pmol/L Decreased filtration Decreased tubular clearance Check Ca Check Ca Acute renal failure Chronic renal failure Cortical hyperostosis Familial hyperphosphatemia Respiratory acidosis Pseudohypoparathyroidism Abnormal PTH Multiple myeloma Hyperthyroidism Acromegaly Postmenopausal Hormonal Nonhormonal Volume contraction Mg deficiency Hyperthermia Tumor calcinosis Hypoparathyroidism Redistribution of phosphorus Increased phosphorus load Check HCO 3 - HCO 3 - 22 mEq/L HCO 3 - 22 mEq/L Anion gap 8-13 Anion gap 13 Miscellaneous causes Acidosis Check LDH, UA, CPK Cell destruction Cutaneous Enteral Parenteral Check anion gap Lactic acidosis Diabetic ketoacidosis Tissue ischemia CPK 110 mg/dl LDH 220 mg/dl UA 7.5 mg/dl PO 4 intake Vit D intoxication Transfusion of stored blood Intravenous PO 4 White phosphorus burns Leukemia Lymphoma Replacement therapy PO 4 -containing laxatives or enemas Etidronate disodium Rhabdomyolysis Hyperpyrexia Hemolysis Neoplastic Tumor lysis syndrome FIGURE 3-166 Approach to hyperphosphatemia. CT, Computed tomography; MRI, magnetic resonance imaging; T, thyroxine; TSH, thyroid-stimulating hormone. (From Healey PM: Common medical diagnosis: an algorithmic approach, ed 3, Philadelphia, 2000, WB Saunders.) HYPERPHOSPHATEMIA ICD-9CM # 995.5 Child Maltreatment Syndrome Hyperphosphatemia

Upload: mahmoud-eid

Post on 15-Jul-2015

723 views

Category:

Health & Medicine

0 download

Report

Download

Embed Size (px):

TRANSCRIPT

1278

UPO4 �1500 mg/day

DecreasedPO4 excretion

Hyperphosphatemia(SPO4 �5.2 mg/dl)

CheckUPO4

MeasureCrCI

CrCI �25 ml/min

CrCI �25 ml/minCa �8.5 mg/dl

Ca 8.5-10.4 mg/dl

PTH �29 pmol/L

PTH 29-81 pmol/L

Decreased filtration

Decreased tubularclearance

CheckCa

Acute renal failureChronic renal failure

Cortical hyperostosisFamilial hyperphosphatemia

Respiratory acidosis

PseudohypoparathyroidismAbnormal PTHMultiple myeloma

HyperthyroidismAcromegalyPostmenopausal

Hormonal

Nonhormonal

Volume contractionMg deficiencyHyperthermiaTumor calcinosis

Hypoparathyroidism

Redistribution of phosphorus

Increasedphosphorus load

CheckHCO3

�

HCO3� �22 mEq/L

Anion gap 8-13

Anion gap �13

Miscellaneous causes

Acidosis

CheckLDH,UA,CPK

Cell destruction

Cutaneous

Enteral

Parenteral

Checkaniongap

Lactic acidosisDiabetic ketoacidosisTissue ischemia

CPK �110 mg/dlLDH �220 mg/dlUA �7.5 mg/dl

PO4 intakeVit D intoxication

Transfusion of stored bloodIntravenous PO4

White phosphorus burns

LeukemiaLymphoma

Replacement therapyPO4-containing laxatives or enemasEtidronate disodium

RhabdomyolysisHyperpyrexiaHemolysisNeoplasticTumor lysis syndrome

FIGURE 3-166 Approach to hyperphosphatemia. CT, Computed tomography; MRI, magnetic resonance imaging; T, thyroxine; TSH, thyroid-stimulating hormone. (From Healey PM: Common medical diagnosis: an algorithmic approach, ed 3, Philadelphia, 2000, WB Saunders.)

HYPERPHOSPHATEMIA ICD-9CM# 995.5 Child Maltreatment Syndrome

Hyperphosphatemia

WS-965 sevelamer carbonate-CHMP AR-MAH deletion proposal ... · SAP Statistical Analysis Plan . ... children with CKD have also demonstrated an association between hyperphosphatemia

Case Presentation - SUNY Downstate Medical Center · Case Presentation Emmanuel Amulraj, M ... hyperphosphatemia that is refractory to oral ... Pathologic study of parathyroid glands

A new perspective on hyperphosphatemia

Acute Tumor Lysis Syndrome - Dogwood Symposium · Case Study # 1 Case Study # 2 ... Hyperphosphatemia ... prevented the risk of acute tumor lysis syndrome

Adherence (Part 1) - The challenge of non-adherence in Adherence (Part 1) - The challenge of non-adherence in hyperphosphatemia Phosphate binders have been shown to be effective in

Hypoparathyroidism: Hyperphosphatemia and Treatment Mary ... · Hypoparathyroidism: Hyperphosphatemia and Treatment Hypoparathyroidism is a rare disorder affecting 65,000 people in

Hypoparathyroidism: Hyperphosphatemia and Treatment Mary ... · PDF fileHYPOPARATHYROIDISM 3 Hypoparathyroidism: Hyperphosphatemia and Treatment Hypoparathyroidism is a rare disorder

medicalnutritiontherapyportfolio.weebly.com · Chronic Kidney Disease Case Study #5 I. Understanding the Disease and Pathophysiology 1) ... A decreasing GFR can result in hyperphosphatemia

Strategies Aiming to Reduce Hyperphosphatemia in Chronic ...nephro-necker.org/pdf/2017/14.pdf · In patients with CKD stages 3– 5, we suggest maintaining serum phosphorus in the

Adenine-induced hyperphosphatemia in a murine … · Adenine-induced hyperphosphatemia in a murine model ... and in the case of end stage failure, ... the study of oral therapies