Dr Kola Tytler MBBS CertHE MBA MRCGPClinical Lead • iatroX
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 NICE NG203.
- 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 NICE NG203.
- Monitoring for symptoms or complications related to mineral and bone disorders, which may be associated with hyperphosphataemia in CKD NICE NG203.
- 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 NICE NG203.
- 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 NICE NG203.
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.