Hypophosphatemia: A Practical Guide to Evaluation and Management

Research output: Contribution to journalReview articlepeer-review


Phosphate plays a critical and diverse role in human physiology. In addition to its importance in skeletal mineralization, it is essential for energy homeostasis, enzyme function, and cell membrane integrity. These diverse functions of phosphate provide an explanation for the range of symptoms and clinical manifestations observed in patients with both acute and chronic causes of hypophosphatemia. Normal phosphate homeostasis involves several major systems, including the gastrointestinal tract, bones, and kidneys. Phosphate balance is maintained directly and indirectly by 1α,25-dihydroxyvitamin D3, parathyroid hormone, and the osteocyte-derived phosphatonin fibroblast growth factor 23. This review discusses normal phosphate homeostasis, the clinical manifestations and causes of hypophosphatemia, and an approach to establish a diagnosis and appropriate management.

Original languageEnglish (US)
Pages (from-to)1091-1099
Number of pages9
JournalEndocrine Practice
Issue number10
StatePublished - Oct 2022


  • fibroblast growth factor 23
  • hypophosphatemia
  • osteomalacia
  • rickets
  • vitamin D

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Endocrinology


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