Hypophosphatemia

Dietary causes of hypophosphatemia are virtually nonexistent, although excessive use of oral phosphate binders (aluminum and magnesium hydroxide antacids) can result in binding of phosphate in the intestine, thus preventing absorption. Generally, when use of oral antacids is excluded, the most common cause of hypophosphatemia is elevated levels of serum calcium caused by increased PTH or malignancy (Silverberg and Bilezikian, 2006). Hypophosphate-mia in association with hypocalcemia is usually caused by renal wasting or is seen in severe illness. One form of infant hypophosphatemic rickets is transmitted as an autosomal dominant trait (Box 35-15).

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