{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T04:04:12Z","timestamp":1789358652067,"version":"build-2803163510"},"reference-count":41,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,13]],"date-time":"2026-09-13T00:00:00Z","timestamp":1789257600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,9,13]],"date-time":"2026-09-13T00:00:00Z","timestamp":1789257600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Internal Medicine Journal"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Hypophosphataemia is a common electrolyte disorder which can have clinically significant consequences for bone, muscle, neurological and haematological function. Its causes range from transient transcellular shifts in hospitalised patients to chronic renal phosphate\u2010wasting disorders mediated by fibroblast growth factor 23 (FGF23). A stepwise diagnostic approach enables identification of the underlying aetiology and guides management. While most cases are managed with removal of causative factors and phosphate supplementation, burosumab has revolutionised the treatment of patients with chronic FGF23\u2010mediated hypophosphataemia. This review provides a practical framework for the evaluation and management of hypophosphataemia in adults, with focussed discussion of iron infusion\u2010associated hypophosphataemia, X\u2010linked hypophosphataemia and tumour\u2010induced osteomalacia.<\/jats:p>","DOI":"10.1111\/imj.70645","type":"journal-article","created":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T03:45:00Z","timestamp":1789357500000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Hypophosphataemia in adults: approach to diagnosis and management"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7810-9880","authenticated-orcid":false,"given":"Kajanan","family":"Parameshwaran","sequence":"first","affiliation":[{"name":"Department of Endocrinology and Metabolism Concord Repatriation General Hospital  Sydney New South Wales Australia"},{"name":"Concord Clinical School, Faculty of Medicine and Health University of Sydney  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mawson","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism Concord Repatriation General Hospital  Sydney New South Wales Australia"},{"name":"Concord Clinical School, Faculty of Medicine and Health University of Sydney  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kirtan","family":"Ganda","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism Concord Repatriation General Hospital  Sydney New South Wales Australia"},{"name":"Concord Clinical School, Faculty of Medicine and Health University of Sydney  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,13]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-8587(19)30426-7"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.beem.2023.101851"},{"key":"e_1_2_11_4_1","first-page":"17","article-title":"Chronic musculoskeletal disorders due to FGF23\u2010mediated hypophosphataemia","volume":"11","author":"Kumar S","year":"2022","journal-title":"Endocrinol Today"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1038\/ki.1996.264"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00467-009-1273-z"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1359\/JBMR.0301264"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjmed.2005.02.014"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.g3172"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2012.03.024"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2011-1319"},{"key":"e_1_2_11_12_1","doi-asserted-by":"crossref","DOI":"10.1186\/s12937-024-00982-w","article-title":"The association between serum phosphate and length of hospital stay and all\u2010cause mortality in adult patients: a cross\u2010sectional study","volume":"23","author":"Zhou Y","year":"2024","journal-title":"Nutr J"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm13237165"},{"key":"e_1_2_11_14_1","doi-asserted-by":"crossref","first-page":"371","DOI":"10.1016\/j.therap.2023.07.007","article-title":"Drug\u2010related hypophosphatemia: descriptive study and case\/non\u2010case analysis of the French national pharmacovigilance database","volume":"79","author":"Thillard E","year":"2023","journal-title":"Therapie"},{"key":"e_1_2_11_15_1","doi-asserted-by":"crossref","first-page":"197","DOI":"10.1007\/s40264-019-00888-1","article-title":"Drug\u2010induced hypophosphatemia: current insights","volume":"43","author":"Megapanou E","year":"2019","journal-title":"Drug Saf"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11154-024-09926-5"},{"key":"e_1_2_11_17_1","doi-asserted-by":"crossref","first-page":"v94","DOI":"10.1093\/jbmrpl\/ziae140","article-title":"Harmonized tubular maximum phosphate reabsorption per glomerular filtration rate reporting in adults and children in Australia and New Zealand","volume":"9","author":"Chiang C","year":"2025","journal-title":"JBMR Plus"},{"key":"#cr-split#-e_1_2_11_18_1.1","unstructured":"Australian Government Department of Health Disability and Ageing.New Medicare Benefits Schedule (MBS) item for fibroblast growth factor 23 (FGF\u201023) testing for patients with a high pre\u2010test probability of X\u2010linked hypophosphatemia (XLH) to determine eligibility for a relevant treatment on the Pharmaceutical Benefits Scheme (PBS)(updated 2025 Oct 15"},{"key":"#cr-split#-e_1_2_11_18_1.2","unstructured":"cited 2026 May 25). Available from URL:https:\/\/www.mbsonline.gov.au\/internet\/mbsonline\/publishing.nsf\/650f3eec0dfb990fca25692100069854\/48c09ae96488a340ca258cba00162c2b\/$FILE\/PDF%20Version%20-%20New%20Medicare%20Benefits%20Schedule%20item%20for%20Fibroblast%20growth%20factor%2023%20(FGF\u201023)%20testing.pdf"},{"key":"e_1_2_11_19_1","unstructured":"Advanced Pharmacy Australia.Phosphate preparations: comparative information. Australian Injectable Drugs Handbook (10th Edition)(updated Jul 2026). 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