ANGELES UNIVERSITY FOUNDATION

Angeles City
COLLEGE OF ALLIED MEDICAL PROFESSIONS

CLINICAL CHEMISTRY 2 LABORATORY

1ST SEM, A.Y. 2016-2017

PHOSPHATE

Submitted by:
Group 1
BSMT 3-D
Group Leader: Beltran, Cherish Inna S.
Members: Balatbat, Allyson M.
De Jesus, Roselle Ivy L.
Miranda, Alda Janelle M.

Submitted to:
Maam Anna Kamile Suyat
Maam Engracia Arceo
CC02 Laboratory Professors

I.

Physiologic

II.

Phosphate is found everywhere in living cells, phosphate compounds

participate in many of the most important biochemical processes. The genetic
materials deoxyribonucleic acid and ribonucleic acid are complex
phosphodiesters. Most coenzymes art esters of phosphoric or pyrophosphoric
acid. The most important reservoirs of biochemical energy are ATP, creatine
phosphate, and PEP. Phosphate deficiency can lead to ATP depletion, which is
ultimately responsible for many of the clinical symptoms observed in
hypophosphatemia.
Alterations in the concentration of 2,3-biphosphoglycerate in RBCs affect the
affinity of hemoglobin for oxygen, with an increase facilitating the release of
oxygen in tissue and a decrease making oxygen bound to hemoglobin less
available. By affecting the formation of 2,3-BPG, the concentration of
inorganic phosphate indirectly affects the release of oxygen from hemoglobin.
Transcellular shifts of phosphate are a major cause of hypophosphatemia in
blood. That is, an increased shift of phosphate into cells can deplete phosphate
in the blood. Once phosphate is taken up by the cell, it remains there to be
used in the synthesis of phosphorylated compounds, As these phosphate
compounds are metabolized, inorganic phosphate slowly leaks out of the cell
into the blood, where it is regulated principally by the kidney.

Clinical Significance

Hypophosphatemia
1. Alcohol abuse most common cause
2. Primary hyperparathyroidism
3. Avitaminosis D
4. Myxedema

Occurs in about 1-5% of hospitalized patients. It increases to 20%-40% with the

following disorders: diabetic ketoacidosis, chronic obstructive pulmonary disease,
asthma, malignancy, anorexia nervosa and alcoholism. In ICU patients with sepsis, the
incidence increases to 60%-80%. In addition, hypophosphatemia cab also be caused by
increased renal excretion, as with hyperparathyroidism and decreased intestinal
absorption, as with Vitamin D deficiency. Most cases are moderate and seldom cause
problems, sever hypophosphatemia requires monitoring and replacement therapy.

Hyperphosphatemia
1. Hypoparathyroidism
2. Renal failure (tubular failure)
3. Lymphoblastic leukemia
4. Hypervitaminosis D
Patients who are at greater risk for hyperphosphatemia are those with acute or chronic
renal failure. An increase intake of phosphate or increase release of cellular phosphate
may also cause hyperphosphatemia. Neonates are especially susceptible to
hyperphosphatemia caused by increased intake, such as from cow's milk of laxatives.
Increase breakdown of cells can sometimes lead to hyperphosphotemia, as with severe
infections, intensive exercise, neoplastic disorders or intravascular hemolysis.
Hypoparathyroidism may also cause hyperphosphatemia.

III.

Methods and Reference Values

Ammonium molybdate method (Fiske Subbarow Method)
The most commonly used method to measure serum inorganic phosphate
Most common reducing agent: Pictol (Amino Naphthol Sulfonic Acid)
Other reducing agents:
1. Elon (Methyl Amino Phenol)
2. Ascorbic acid
3. Senidine (N-phenyl-p-phenylene diamine hydrochloride)
End product: Ammonium-molybdate complex which can be measured by UV
absorption at 340nm (unstable)
Reduced form: molybdenum blue, a stable blue chromophore and determined
between 600-700nm.
pH: maintained in the acid range
REFERENCE RANGES FOR INORGANIC
PHOSPHORUS

SERUM
Neonate
Children 15y
Adult
Urine (24h)

IV.

Important Notes

1.45-2.91 mmol/L
1.07-1.74 mmol/L
0.78-1.42 mmol/L
13-42 mmol/L

4.5-9.0 mg/dL
3.3-5.4 mg/dL
2.4-4.4 mg/dL
1.4.1.3
g/d

V.

Phosphate is a charged particle (ion) that contains the mineral phosphorus.

The body needs phosphorus to build and repair bones and teeth, help nerves
function, and make muscles contract.
Most (about 85%) of the phosphorus contained in phosphate is found in
bones. The rest of it is stored in tissues throughout the body. Phosphate
compounds participate in many of the most biochemical processes.
The kidneys help control the amount of phosphate in the blood. Extra
phosphate is filtered by the kidneys and passes out of the body in the urine.
A high level of phosphate in the blood is usually caused by a kidney problem.
Phosphate deficiency on the other hand, can lead to ATP depletion.
Prolonged standing at room temperature and hemolyzed samples causes
elevations on Phosphate values.

References

Bishop, Michael L., et al. Clinical Chemistry Principles, Techniques and

Correlations. 7th ed. Lippincott Williams and Wilkins. 2013. Pages 367-370.
http://www.webmd.com/a-to-z-guides/phosphate-in-blood