How hypocalcemia can result from hyperphosphatemia
Hyperphosphatemia can induce hypocalcemia through an increase in calcium × phosphorus product with subsequent precipitation of calcium phosphate salts in soft tissues. This commonly occurs with excessive enteral or parenteral phosphate administration (during treatment of hypophosphatemia) or with massive release of intracellular phosphate in patients with tumor lysis syndrome, severe hemolysis, or rhabdomyolysis. It can also occur in acute kidney injury or advanced CKD due to decreased renal phosphorus excretion.
