Key messages

• Severe hyperphosphatemia is rare.

• The most common causes of hyperphosphatemia are renal failure and transcellular shift from intracellular to extracellular fluid.

• Clinical effects are often due to concommitant hypocalcemia.

• Treatment commences with elucidating etiology.

• Further treatment consists of decreasing phosphate load, increasing renal excretion, or causing transcellular shifts from extracellular to intracellular fluid.

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