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Medicina Clínica (English Edition) Etiology of hypophosphatemia in adults
Journal Information
Vol. 164. Issue 1.
Pages 30-37 (January 2025)
Vol. 164. Issue 1.
Pages 30-37 (January 2025)
Review
Etiology of hypophosphatemia in adults
Etiología de la hipofosfatemia en el adulto
Nuria Puente Ruiza,b,
Corresponding author
nuria.puente@scsalud.es

Corresponding author.
, M. Carmen Valero Díaz de Lamadrida, José A. Rianchoa,b
a Servicio de Medicina Interna, Hospital Universitario Marqués de Valdecilla; Departamento de Medicina y Psiquiatría, Universidad de Cantabria; Instituto de Investigación Marqués de Valdecilla (IDIVAL), Santander, Spain
b Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER, ISCIII), Madrid, Spain
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Tables (3)
Table 1. Diagnostic approach to the causes of hypophosphatemia, both acute and chronic, based on FGF23 levels and phosphaturia (assessed by urine P and tubular phosphate reabsorption rate [TRP]).
Tables
Table 2. Prevalence in different series of patients with acute hypophosphatemia according to the population studied.10
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Table 3. Main biochemical characteristics of the most common genetic disorders causing chronic hypophosphatemia, grouped by pathophysiological mechanism.48
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Abstract

Long-term hypophosphatemia, defined by serum phosphorus (P) levels <2.5mg/dl, impairs the development and quality of mineralized tissue of the skeletal, dental, and auditory systems. P homeostasis depends mainly on intestinal absorption and renal excretion. Hypophosphatemia may be due to the redistribution of P to the intracellular space, increased renal losses, or decreased intestinal absorption. Hypophosphatemia can be categorized as acute or chronic, depending on the time course. Most cases, either acute or chronic, are due to acquired causes. However, some chronic cases may have a genetic origin. Accurate and early diagnosis, followed by adequate treatment, is essential to limit its negative effects on the body.

Keywords:
Phosphate
Acute hypophosphatemia
Chronic hypophosphatemia
Vitamin D
Genetic hypophosphatemia
Resumen

La hipofosfatemia, definida por cifras de fósforo (P) sérico <2,5mg/dl, a largo plazo perjudica el desarrollo y la calidad del tejido mineralizado del sistema esquelético, dental y auditivo. Su homeostasis depende principalmente de la absorción intestinal y de la excreción renal. La hipofosfatemia puede deberse a algunos de estos mecanismos: redistribución del P al espacio intracelular, aumento de las pérdidas renales o disminución de la absorción intestinal. Según el curso temporal, las hipofosfatemias se pueden clasificar en agudas o crónicas, con diferentes manifestaciones clínicas y mecanismos etiopatogénicos. Las agudas suelen ser de causa adquirida; las crónicas, en su mayoría, también, aunque pueden ser de origen genético. El diagnóstico preciso y precoz, seguido de un tratamiento optimizado, resulta fundamental para limitar sus efectos negativos sobre el organismo.

Palabras clave:
Fosfato
Hipofosfatemia aguda
Hipofosfatemia crónica
Vitamina D
Hipofosfatemia genética

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