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Care During Chemotherapy and Beyond

Hyperphosphatemia (High Phosphate)



What is hyperphosphatemia?

Hyperphosphatemia may be described as high levels of inorganic phosphate in the blood.

The normal range for phosphorous is 2.5-4.5 mg/dL.  Normal values may vary from laboratory to laboratory.

Phosphate, or phosphorous, is similar to calcium, as it is found in your teeth and bones. Like calcium, you need vitamin D in order to absorb phosphate properly.

The kidneys excrete phosphate. Therefore, the most common cause of increased phosphate levels (or hyperphosphatemia) is the kidney's inability to get rid of phosphate. Hyperphosphatemia is also seen in people who have:

  • Excessive dietary intake of phosphate (also from laxatives or enemas)
  • Your body may have a deficiency in calcium or magnesium, or it may have too much Vitamin D, resulting in hyperphosphatemia.
  • Severe infections can cause increased phosphate levels, resulting in hyperphosphatemia.
  • Cell destruction - from chemotherapy, when the tumor cells die at a fast rate. This can cause tumor lysis syndrome.
  • Problems with your breathing (respiratory acidosis)
  • You may have high phosphate levels from prolonged exercise, which causes muscle damage. Certain athletes and distance runners may get this, called rhabdomyolysis.
  • You may have problems with your thyroid, parathyroid gland, or other hormones, causing increased levels of phosphate in your blood and resulting in hyperphosphatemia
  • Kidney failure can cause hyperphosphatemia

What are some symptoms of hyperphosphatemia to look for?

  • Signs of hyperphosphatemia include an elevated blood phosphate level. Other electrolyte values are likely to be affected, depending on your disease.
  • There are no symptoms of hyperphosphatemia. You may not know that your blood phosphate levels are elevated. The symptoms that you have are due to the underlying disease.

Things you can do about hyperphosphatemia:

  • Try to exercise, and maintain your optimal functioning. Make a daily walk either alone, or with a friend or family member a part of your routine. Even light walking may help you to promote the flow of oxygen in your lungs and blood (oxygenation), and make you feel better. 
  • Make sure you tell your doctor, as well as all healthcare providers, about any other medications you are taking (including over-the-counter, vitamins, or herbal remedies).  These can cause  interactions with other medications.
  • Remind your doctor or healthcare provider if you have a history of diabetes, liver, kidney, or heart disease.
  • Keep yourself well hydrated. Drink two to three quarts of fluid every 24 hours, unless you are instructed otherwise.
  • If you experience symptoms or side effects, especially if severe, be sure to discuss them with your health care team.  They can prescribe medications and/or offer other suggestions that are effective in managing such problems.
  • Keep all your appointments.

Drugs that may be prescribed by your doctor:

There are few medications that may be prescribed for high blood phosphate levels. The treatment of your high blood phosphate levels is to identify the underlying cause, and to treat that condition. 

  • Aluminum hydroxide - can be used to bind phosphate in your blood. However, many do not use this, because of fear of aluminum toxicity.
  • Calcium Carbonate tablets - This is the most common medication prescribed for increased blood phosphate levels (hyperphosphatemia). These pills, taken 3 times a day with meals, will bind to the phosphate in your bloodstream, and lower your blood phosphate levels.

When to call your doctor or health care provider:

  • Severe constipation, unrelieved by laxatives, lasting 2 to 3 days.
  • Nausea that interferes with your ability to eat, and is unrelieved by any prescribed
    medications.
  • Vomiting (vomiting more than 4-5 times in a 24 hour period).
  • Diarrhea (4-6 episodes in a 24-hour period), unrelieved with taking anti-diarrhea medication and diet modification.

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Note:  We strongly encourage you to talk with your health care professional about your specific medical condition and treatments. The information contained in this website is meant to be helpful and educational, but is not a substitute for medical advice.