Hyperphosphatemia and Its Causes
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Questions and Answers

Which of the following is NOT a major cause of hyperphosphatemia?

  • Renal failure
  • Hyperthyroidism (correct)
  • Hypoparathyroidism
  • Acute metabolic acidosis

What adverse effects are associated with hyperphosphatemia?

  • Vascular calcification
  • Endothelial dysfunction
  • Oxidative stress
  • All of the above (correct)

Increased phosphate levels can lead to inhibition of which vitamin D synthesis?

  • 1,25-dihydroxy-vitamin D (correct)
  • Vitamin D1
  • 25-hydroxy-vitamin D
  • Vitamin D3

How can increased parathyroid hormone due to hyperphosphatemia affect myocardium?

<p>Impaired myocardial energy production (A)</p> Signup and view all the answers

What mechanism is suggested by current evidence for the adverse outcomes of hyperphosphatemia in vascular systems?

<p>Direct effect on vascular calcification (B)</p> Signup and view all the answers

Which of the following is NOT shown to increase due to hyperphosphatemia?

<p>Insulin (A)</p> Signup and view all the answers

Study Notes

Hyperphosphatemia

  • Elevated level of phosphate in the blood, an electrolyte disorder

Major Causes

  • Hypoparathyroidism
  • Renal failure
  • Acute metabolic acidosis
  • Addison's disease

Risks and Outcomes

  • Major risk factor for death, cardiovascular events, and vascular calcification in patients with and without kidney disease
  • Direct effect of phosphate on vascular calcification, leading to adverse outcomes

Mechanisms of Hyperphosphatemia

  • Reduced glomerular filtration rate
  • Inadequate dialysis
  • Nonadherence to dietary restriction or dialysis regimen
  • Direct vascular injury:
    • Vascular calcification
    • Endothelial dysfunction
    • Oxidative stress
  • Increased fibroblast growth factor 23 through unknown mechanisms
  • Inhibition of 1,25-dihydroxy-vitamin D synthesis, leading to:
    • Decreased cardiac contractility
    • Coronary artery calcification
    • Myocardial fibrosis
    • Proinflammatory effects
  • Increased parathyroid hormone, leading to:
    • Proinflammatory effects
    • Increased interleukin-6
    • Impaired myocardial energy production

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Description

Learn about hyperphosphatemia, an electrolyte disorder with elevated phosphate levels in the blood, its major causes, and risks.

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