What are the key clinical features to consider when diagnosing hyperphosphataemia in a primary care setting?

Key clinical features to consider when diagnosing hyperphosphataemia in primary care include:

• Assessment of serum phosphate levels, especially in patients with chronic kidney disease (CKD) stage 4 or 5, as hyperphosphataemia is more common in advanced CKD ².
• Consideration of factors affecting phosphate levels such as diet, adherence to phosphate binders, vitamin D status, parathyroid hormone levels, serum calcium, and medications that may influence phosphate metabolism ².
• Monitoring for symptoms or complications related to mineral and bone disorders, which may be associated with hyperphosphataemia in CKD ².
• Recognition that routine measurement of phosphate is not recommended in adults with a glomerular filtration rate (GFR) of 30 ml/min/1.73 m2 or more (CKD stages G1-G3) unless clinically indicated ².
• In patients with CKD stage 4 or 5, serum phosphate should be measured and monitored regularly, with frequency guided by clinical circumstances and test results ².

In primary care, hyperphosphataemia diagnosis is largely linked to identifying elevated serum phosphate in the context of CKD and related mineral bone disorders, rather than specific clinical symptoms alone.