HYPOphosphatemia HYPERphosphatemia A 35 year-old who is being treated for nephrolithiasis develops diffuse weakness Introduction Introduction Causes include hyperparathyroidism osmotic diuresis excessive IV glucose treatment of DKA refeeding syndrome in alcoholics Causes include usually iatrogenic rhabdomyolysis hypoparathyroid hypocalcemia Presentation Presentation Symptoms diffuse muscle weakness flaccid paralysis due to decreased ATP production Symptoms heart block soft tissue calcification Evaluation Evaluation EKG findings heart block Treatment Treatment Replace potassium phosphate sodium phosphate Decrease dietary phosphorous Aluminum hydroxide Hydration and acetazolamide Dialysis Prognosis, Prevention, and Complications Prognosis, Prevention, and Complications If severe may cause rhabdomyolysis hemolysis