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What Is Hyperphosphatemia?

Medically Reviewed by Melinda Ratini, DO, MS on June 01, 2021

Hyperphosphatemia is a condition that means you have high levels of phosphorus in your body. It can happen due to your diet or a change in your kidneys’ function. Often, hyperphosphatemia has no symptoms. 

Understanding Hyperphosphatemia

‌Hyperphosphatemia commonly affects people with chronic kidney disease (CKD). Properly functioning kidneys remove extra phosphorus that ends up in your body. But with CKD, your kidneys can’t remove the phosphorus, causing it to build up in your body. High levels of phosphorus can damage your body. 

This condition can make your bones weaker because it pulls calcium out of your bones. When this happens, calcium deposits can occur in your blood vessels, lungs, eyes, and heart. 

‌‌Hyperphosphatemia can increase your risk of stroke, heart attack, and even death. 

Signs and Symptoms of Hyperphosphatemia

‌Though hyperphosphatemia typically goes unnoticed, you must look for these signs and symptoms: ‌

  • Muscle cramps
  • Numbness around your mouth
  • Tetany
  • Bone and joint pain
  • Rash

‌In most cases, you are more likely to have symptoms of the underlying cause of your hyperphosphatemia, like kidney problems. These are the common symptoms of kidney failure: ‌

  • Fatigue
  • Shortness of breath
  • Nausea and vomiting
  • Sleeping problems
  • Anorexia

‌In severe cases, you may experience hypocalcemia or decreased calcium levels. This can cause seizures and other neurological problems due to kidney failure. You should talk to a doctor immediately if you have any of these symptoms. 

Understanding Phosphate Levels

‌You can get phosphorus from your food, drinks, and medicine. Phosphorus, calcium, and vitamin D work to make your bones strong and healthy. Foods that are high in phosphate include the following: ‌

  • Red meat
  • Milk and cheese
  • Fish
  • Dried beans and peas
  • Nuts and nut butter
  • Whole grain bread

‌Your body stores phosphorus in the form of phosphate. A majority of the phosphate in your body crystallizes in the bone. The other part is in your muscles. When you have hyperphosphatemia, the phosphate levels in your body become very high. 

Your kidneys are supposed to excrete 90% of your daily phosphate load. Your gastrointestinal tract excretes the remaining phosphate. When you have kidney problems, your phosphate levels can’t be regulated. 

Role of Your Kidneys

‌Your kidneys play an important role in maintaining phosphorus levels in your body. If your kidneys don’t function properly, you’re more likely to develop hyperphosphatemia. This leads to phosphorus building up in your blood. 

Your kidneys also turn vitamin D into a material to strengthen your bones. With CKD, your kidneys can’t use the vitamin D, making your bones weaker. Kidney failure makes your blood unbalanced.  

Diagnosis and Treatment of Hyperphosphatemia

‌Since hyperphosphatemia commonly occurs without symptoms, it can be hard to diagnose. Your doctor will check the phosphate concentration in your blood to detect hyperphosphatemia. They will also measure your serum protein, lipid, and bilirubin concentrations. 

To treat this condition, your doctor will focus on reducing your phosphate intake. You may be asked to avoid certain foods. Treatment will also include taking phosphate-binding drugs with your food. 

If you have late-stage chronic renal failure, your doctor may prescribe dialysis, dietary phosphorus restrictors, phosphate-binding medication, and vitamin D‌‌

If your hyperphosphatemia is left untreated, you may be at risk of developing other life-threatening conditions. These include the following: ‌

  • Secondary hyperparathyroidism
  • Renal osteodystrophy, a bone disease caused by kidney failure 
  • Metastatic calcification, or deposition of calcium, in blood vessels and soft tissue‌

Managing Hyperphosphatemia

‌To manage your hyperphosphatemia, you can try the following strategies. 

Diagnose the problem. Knowing that you have hyperphosphatemia can be the trickiest part of managing this condition. Once your doctor diagnoses your condition, they will give you a treatment plan to address the underlying cause.

Limit your phosphate intake. In addition to using phosphate-binding medication, you will have to decrease your phosphate intake. Knowing how your medications work with your diet is important. Foods high in phosphorus, including protein-rich foods, must be avoided if you have hyperphosphatemia. 

Phosphorus is also added to fast foods, ready-to-eat foods, canned foods, and bottled drinks. Processed foods can have high levels of phosphorus. Limiting these foods in your diet will help you reduce your phosphate intake.

‌‌Improve renal excretion. This is used if you have normal renal function. You may be required to do this at the hospital to remove excess phosphorus from your body. Your doctor will use saline and forced dialysis to improve your renal excretion.

WebMD Medical Reference

Sources

SOURCES:

American Journal of Health-System Pharmacy: “Hyperphosphatemia and phosphate binders.”

‌American Kidney Fund: “High Phosphorus (hyperphosphatemia).”

Goyal, R., Jialal, I. StatPearls. StatPearls Publishing, 2020.

‌Medscape: “Hyperphosphatemia.”

‌National Kidney Foundation: “Phosphorus and Your Diet.”

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