Phosphorus, combined with oxygen, creates phosphate (PO4), an integral component required to maintain the body’s acid base balance. It is used for energy production, bone growth, muscle and nerve function. Intracellular phosphate is an essential component of the cellular structure, cytoplasm and mitochondrium. Approximately 85% is combined with calcium to form bone and teeth, 10% found in soft tissues. The remainder is found in nerve tissue, intercellularly or in plasma serum. Almost all of the phosphorus found in the extracellular fluid space is in the form of inorganic phosphate which can be measured to assess body phosphorus stores.
Phosphorus
Phosphorus
phosphorus, P, PO4, inorganic phosphate,
Possible causes of hyperphosphatemia include
- Advanced renal failure – GFR <30 significantly reduces the capacity to eliminate phosphate resulting in raised levels
- Inadequate renal excretion in the absence of chronic kidney disease also occurs in pseudohypoparathyroidism, hypoparathyroidism, and parathyroid suppression from hypercalcaemia due to vitamin A/D excess
- Phosphate overload from large transcellular shift of phosphate into the extracellular space that exceeds the kidneys ability to process it in a timely manner : tumour lysis syndrome, rhabdomyolysis, sepsis, DKA
- Excessive oral phosphate administration
Possible cause of hypophosphataemia
Clinically significant acute hypophosphatemia occurs in relatively few clinical settings such as:
- Severe respiratory alkalosis
- After DKA treatment
- During carbohydrate refeeding in severely malnourished patients / starvation states / alcoholism patients
- In patients receiving TPN
- Severe respiratory alkalosis
- Acute alcohol use disorder
- Severe burns
- Long term steroid use
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5mL venous serum or plasma
Enfer Medical
Tests/Assays
Enfer Medical offers enzymatic technology for the quantitative assay for phosphorus. This test is CE-IVD certified.
Patient
Request Form
For clients using the Enfer Medical Client Portal, the Enfer Medical Patient Request Form (PRF) will be generated when you have completed your “Test Request” within the portal linked below.
Please note that samples suspected of containing high risk pathogens such as Mycobacterium tuberculosis should be clearly identified on the form and packed separately from other samples.
Results are available next working day.
This assay is available seven days a week.
Packaging
The packaging/preparation of samples for delivery to the laboratory are required to be in adherence to all national regulations for the safe transport of biological materials. HSE guidance can be reviewed HERE.
There are specific packaging instructions and labelling requirements requiring triple packaging including:
- Primary leak-proof container – tube or vial containing the sample.
- Secondary watertight container, with absorbent material, intended to protect the primary container.
- Outer container protects the secondary container.
- Patient Request forms must be placed between the secondary container and the outer shipping container.
Further information on the packaging/preparation of samples for delivery to the laboratory is contained within the Enfer Medical Laboratory User Manual which clients are provided with.
Storage & Stability
Specimens must be tested within 1 day of collection and stored at 2-8°C.
Samples
In addition to the packaging of samples, the transport/delivery of clinical samples to the laboratory is required to be in adherence to all national regulations for the safe transport of biological materials. Enfer Medical provides a fully compliant logistics service, aligned with clients’ testing requirements.
Prompt transport of specimens:
To ensure prompt testing of samples and release of results within the published test turnaround times, samples should arrive to the laboratory by 18:00. Test turnaround time is measured from receipt of the sample at the laboratory until the time the authorised results are reported to users.
of Samples
In rare cases specimens may not be suitable for testing on arrival to the laboratory. In that case the sample will be rejected at the receipt stage and the service user will be notified immediately and an explanation as to why the sample could not be processed will be provided. Reasons why samples cannot be processed include but are not limited to:
- Samples received beyond the stability limits and/or not at the correct temperature indicated for each test.
- Incorrect sample type received.
- Leaking samples, sample not received or sample insufficient for analysis as stated below within sample requirements.
- Non-compliant samples or request forms i.e. those missing sample date information, missing sample test request and/or missing sample site/type information.
- Samples received without the necessary patient identifiers.
Our Services
Quantitative results for Phosphorus are reported numeric value in mmol/L. Please contact us for more information on the reference ranges used at Enfer Medical.
Critical results are communicated in accordance with the Communication of critical results for patients in the community- national laboratory handbook CSP041/2019
Accessing
Your Results
Following receipt at the Laboratory, results should be available on the next working day and will be reported to the referring clinician via the Enfer Medical Client Portal or in a format agreed with clients.
Established clients can login to the portal using the link above.