When there is too much phosphate in your body, this condition is called hyperphosphatemia. Phosphate is an electrically charged substance (electrolyte) that contains the mineral phosphorus. It helps strengthen your bones and teeth, produce energy, and build cell membranes. Too much phosphate, however, can increase your risk of heart attack and stroke and cause a variety of muscle and bone issues.

Hyperphosphatemia is also frequently a sign of kidney damage and is most often seen in people with chronic kidney disease (CKD), particularly in end-stage kidney disease (ESKD). Learn more about this condition, like what symptoms to look out for and how to treat it.*

What are the symptoms of hyperphosphatemia?

Many people with high phosphate levels don’t experience any noticeable symptoms, but in people with CKD, the condition may cause a drop in their blood calcium levels.

In turn, this drop may lead to the following symptoms:

• Bone and joint pain
• Itchy skin or rash
• Muscle cramps or spasms
• Tingling or numbness around the mouth
• Weakened, brittle bones

What causes hyperphosphatemia?

Under normal circumstances, your kidneys help keep your phosphate levels in balance by removing unnecessary phosphate from your body. If your kidneys are not functioning properly, they are unable to remove extra phosphate from your blood quickly enough to keep the levels balanced.

Other possible causes of hyperphosphatemia include:

• Cell damage
• Diabetic ketoacidosis (high levels of acids called ketones in the blood of diabetics)
• Elevated levels of vitamin D
• Certain injuries, including those causing muscle damage
• Low parathyroid hormone levels
• Serious systemic infections

Your blood phosphate level can also rise abruptly if you receive a phosphorus-containing laxative as preparation for a colonoscopy.

How is hyperphosphatemia treated?

The three most common ways of treating hyperphosphatemia are diet, dialysis, and medication.

Diet

Prescribed changes to your diet will include eating plenty of fresh produce and healthy protein, such as fish, poultry, nuts, bean, and eggs.

You will also need to limit your intake of high-phosphorus foods, such as:

• Milk and processed cheeses
• Red meat 
• Frozen meals
• Snacks high in salt and sugar
• Soft drinks (soda/cola)
• Packaged foods, including meat, that contain additives and preservatives
• Bread, especially white bread and other highly processed types of bread

Dialysis

Healthy dietary habits are critical but will not likely fix the problem by themselves. If your kidneys have already sustained extensive damage, dialysis may be necessary to remove excess phosphate from your blood, along with other excess minerals and metabolic waste products. 

Medication

In addition to dietary changes and dialysis, your doctor may prescribe medications to help reduce the amount of phosphate absorbed by your intestines. 

These can include:

• Calcium-based phosphate binders such calcium acetate and calcium carbonate
• Lanthanum (brand name Fosrenol)
• Sevelamer hydrochloride (brand name Renagel) 
• Sevelamer carbonate (brand name Renvela)

You may also be given ACE inhibitors, ARBs, or diuretics to treat hypertension (high blood pressure), which will take pressure off of your kidneys and blood vessels.

High levels of blood phosphate can increase your risk for serious health complications. Treating hyperphosphatemia as soon as possible helps prevent additional issues from occurring.

*Watson, S. (2018, Nov. 12). What is Hyperphosphatemia? Healthline. https://www.healthline.com/health/hyperphosphatemia