Hyperphosphorémie

Résumé

Hyperphosphatemia is an electrolyte disorder in which there is an elevated level of phosphate in the blood. Most people have no symptoms while others develop calcium deposits in the soft tissue. Often there is also low calcium levels which can result in muscle spasms. Causes include kidney failure, pseudohypoparathyroidism, hypoparathyroidism, diabetic ketoacidosis, tumor lysis syndrome, and rhabdomyolysis. Diagnosis is generally based on a blood phosphate levels of greater than 1.46 mmol/L (4.5 mg/dL). Levels may appear falsely elevated with high blood lipid levels, high blood protein levels, or high blood bilirubin levels. Treatment may include eating a phosphate low diet and antacids, like calcium carbonate, that bind phosphate. Occasionally intravenous normal saline or dialysis may be used. How commonly it occurs is unclear. Signs and symptoms include ectopic calcification, secondary hyperparathyroidism, and renal osteodystrophy. Abnormalities in phosphate metabolism such as hyperphosphatemia are included in the definition of the new chronic kidney disease-mineral and bone disorder (CKD-MBD). Hypoparathyroidism: In this situation, there are low levels of parathyroid hormone (PTH). PTH normally inhibits reabsorption of phosphate by the kidney. Therefore, without enough PTH there is more reabsorption of the phosphate leading to a high phosphate level in the blood. Chronic kidney failure: When the kidneys are not working well, there will be increased phosphate retention. Drugs: hyperphosphatemia can also be caused by taking oral sodium phosphate solutions prescribed for bowel preparation for colonoscopy in children. The diagnosis of hyperphosphatemia is made through measuring the concentration of phosphate in the blood. A phosphate concentration greater than 1.46 mmol/L (4.5 mg/dL) is indicative of hyperphosphatemia, though further tests may be needed to identify the underlying cause of the elevated phosphate levels. It is considered significant when levels are greater than 1.6 mmol/L ( 5 mg/dL).

Source officielle

https://fr.wikipedia.org/wiki/Hyperphosphorémie

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Concepts associés (14)

Phosphate binder

Phosphate binders are medications used to reduce the absorption of dietary phosphate; they are taken along with meals and snacks. They are frequently used in people with chronic kidney failure (CKF), who are less able to excrete phosphate, resulting in an elevated serum phosphate. These agents work by binding to phosphate in the GI tract, thereby making it unavailable to the body for absorption. Hence, these drugs are usually taken with meals to bind any phosphate that may be present in the ingested food.

Rhabdomyolyse

En médecine, la rhabdomyolyse (du grec : rhabdo- : « rayé » myo- : « muscle » et –lysis : « destruction ») est une situation dans laquelle des cellules des muscles squelettiques, se dégradant rapidement, libèrent leur contenu dans la circulation sanguine. Certains produits de dégradation des cellules endommagées, libérés dans le sang, comme la myoglobine, sont nocifs pour les reins et peuvent entraîner une insuffisance rénale.

Hypocalcémie

L’hypocalcémie est un état caractérisé par un taux de calcium dans le sang (calcémie) anormalement bas, indépendamment des autres constantes biologiques. La calcémie (Ca) doit être corrigée avec le taux d’albumine dans le sang, par la formule : Ca corrigée = Ca mesurée en mmol/L + 0,025 × (40 - albuminémie en g/L). Elle est basse en dessous de 2,20 mmol/L. La parathormone et la vitamine D sont les deux éléments principaux permettant de maintenir un taux de calcium correct dans le sang.

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