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Disorders of phosphate metabolism
  1. Jenny Leung,
  2. Martin Crook
  1. Clinical Biochemistry, University Hospital Lewisham, London, UK
  1. Correspondence to Professor Martin Crook, University Hospital Lewisham, clinical biochemistry, London SE136LH, UK; martin.crook{at}


Phosphate in both inorganic and organic form is essential for several functions in the body. Plasma phosphate level is maintained by a complex interaction between intestinal absorption, renal tubular reabsorption, and the transcellular movement of phosphate between intracellular fluid and bone storage pools. This homeostasis is regulated by several hormones, principally the parathyroid hormone, 1,25-dihydroxyvitamin D and fibroblast growth factor 23. Abnormalities in phosphate regulation can lead to serious and fatal complications. In this review phosphate homeostasis and the aetiology, pathophysiology, clinical features, investigation and management of hypophosphataemia and hyperphosphataemia will be discussed.

  • hypophosphataemia
  • hyperphosphataemia
  • phosphate
  • refeeding syndrome

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  • Handling editor Tahir S Pillay.

  • Contributors Both authors contributed to the review article.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Commissioned; internally peer reviewed.