Hypophosphatemia - Differential Diagnosis Algorithm
Appropriately Low Kidney Phosphate Excretion:
• Decreased GI Absorption: Chronic Diarrhea, Antacids, Phosphate Binders, Vitamin D Deficiency
• Transcellular Shift: Refeeding Syndrome, Acute Respiratory Alkalosis, Tumor Genesis Syndrome
Inappropriately High Kidney Phosphate Excretion:
• N Vitamin D: Primary Hyperparathyroidism, TKI, ALK inhibitor, Estrogen based hormonal therapy, IV Bisphosphonate and Denosumab
• ↓Vitamin D: Vit D Deficiency
• N or ↓FGF23: Fanconi Syndrome, (MM, lymphoma, cancer therapy)
• ↑FGF23: Oncogenic, Osteomalacia, Ferric Carboxymaltose, CAR-T cell
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