Endocrinology >>>> Hypophosphatemia

Hypophosphatemia.

A decrease in the concentration of phosphorus ions in the blood plasma below 0.80 mmol / liter is called "hypophosphatemia". Since phosphorus compounds enter the body with food intake, their absorption occurs in the presence of potassium and magnesium, and their concentration is regulated by the work of parathyroid hormone and renal tubules, which are responsible for the excretion of free phosphates from the body with urine, the main causes of hypophosphatemia can be divided into several groups :

Insufficient intake of phosphates from food during fasting, parenteral nutrition or impaired absorption of phosphorus compounds, when drugs (aluminum-containing or magnesium-containing antacids, intravenous infusion of glucose solution, diuretics, hemodialysis) can interfere with the absorption of phosphorus-containing compounds.
Loss of phosphate at the gastrointestinal tract: as a result of malabsorption, diarrhea, vomiting.
Dysfunction of the renal tubules as a result of various diseases (defects of the renal tubules).
Disruption of the parathyroid glands (hyperparathyroidism).
Disorders of phosphorus metabolism due to hypomagnesemia, hypokalemia or vitamin D hypovitaminosis.
As a result of the development of certain diseases: acute gout, acute myocardial infarction, respiratory alkalosis, alcoholism, gram-negative sepsis, diabetic ketoacidosis, neoplasms, paraneoplastic osteomalacia, cachexia, "vitamin D - resistant" rickets, cystinosis, heavy metal poisoning, burns.

Signs of hypophosphatemia are clearly manifested with a significant decrease in the level of phosphorus ions in the blood (below 0.32 mmol / liter) and are reflected:

In muscle weakness,
In violation of bone mineralization,
Heart and / or respiratory failure ,
In the development of convulsive syndrome,
In paresthesia (impaired sensitivity),
In violation of the functions of the diaphragm, paralysis of the respiratory muscles,
In the development of cardiomyopathy,
In the development of rhabdomiliosis,
Confused,
In a possible coma.

Treatment for hypophosphatemia includes several areas:

Accurate diagnosis of the causes of hypophosphatemia;
Treatment of diseases that contribute to its development and accompany hypophosphatemia;
Replenishment of phosphorus compounds by revising the diet and additional intake of phosphorus compounds in the composition of mineral complexes (125 mg of sodium phosphate twice a day);
Correction of metabolic disorders associated with hypomagnesemia and hypokalemia;
Cancellation of diuretics, refusal of antacids or replacing them with antacids containing phosphorus compounds (aluminum phosphate);
Intravenous infusion of phosphates (there is a risk of developing acute hypocalcemia and shock with careless administration, therefore, it is used in exceptional cases when only hypophosphatemia is detected ).

Restoring the balance of phosphates in the body is carried out under the control of a biochemical blood test for the content of phosphorus ions, otherwise excessive introduction of phosphates into the body can provoke hyperphosphatemia.