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Phosphoremia: too low or too high, what does it mean?

Phosphoremia - or phosphatemia - is the concentration of total phosphorus in plasma. According to the definition of phosphatemia, published in version 2024 of the Académie de médecine medical dictionary, it ranges from 1.0 to 1.4 mmol/L in healthy adults, and is slightly higher in children. Hyperphosphatemia and hypophosphatemia correspond respectively to an excess and a deficiency of phosphorus in plasma. Abnormal levels are accompanied by symptoms of varying severity and concern.

Role and importance of phosphorus in the human body

Present in most ingested foods, phosphorus is a mineral essential to the body's proper functioning. It is particularly present in bones and teeth, but also in the blood and all the body's cells. It exists mainly in the form of phosphate, in combination with oxygen. According to the Institut de recherche du bien-être, de la médecine et du sport santé, the main functions of phosphorus are as follows:

  • mineralization of bones and teeth, skeletal strength and structure ;

  • metabolic reactions, structuring of cell membranes, production of cellular energy ;

  • DNA and RNA production, growth ;

  • acid-base balance, maintenance of optimal blood pH.

Definition of Phosphoremia levels

Phosphorus is one of the minerals essential for optimal body function. Its concentration in blood plasma, known as phosphoremia or phosphatemia, is an indicator of good health. Its value should be normal, neither too high nor too low. In healthy adults, phosphoremia is generally between 1.0 and 1.4 mmol/L, according to the French Academy of Medicine. However, it may be higher in certain populations with high energy requirements, such as children and pregnant women. In individuals suffering from kidney failure, phosphorus tends to accumulate in the blood, as its evacuation in the urine is impaired due to kidney dysfunction. When phosphorus levels are too low, doctors refer to hypophosphatemia. Conversely, an excess of phosphorus in the plasma is referred to as hyperphosphatemia.

3. Symptoms and management of hyper phosphatemia

Renal failure is the main cause of hyper Phosphoremia, according to the Centre Hospitalier Universitaire Vaudois. Other causes include bone disease, hypoparathyroidism, diabetic ketoacidosis and sepsis. Sometimes asymptomatic, hyperphosphatemia can be the cause of various symptoms:

  • increased parathormone: inhibition of vitamin D action ;

  • bone weakness and joint pain;

  • precipitation of calcifications in vessels, soft tissues and viscera: risk of stroke, circulatory failure, heart attack, intense pruritus (linked to crystal formation on the skin).

Once hyperphosphatemia has been diagnosed, patients must adopt a low-phosphate diet. This includes avoiding soft drinks, milk, eggs and chocolate. At the same time, they are prescribed medications designed to reduce phosphorus absorption and increase phosphate excretion (binders). If renal failure is the cause of hyperphosphatemia, treatment must also include sufficiently frequent and prolonged dialysis sessions.



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