Electrolyte Imbalance in Renal Disease · NCLEX Exam

What is the likely mechanism of hyperphosphatemia in a patient with acute renal failure?

  1. Markedly increased renal excretion of phosphate
  2. Reduced filtration and excretion by damaged kidneys
  3. Excessive dietary phosphate intake acting alone
  4. Increased conversion of vitamin D to its active form
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Correct answer: Reduced filtration and excretion by damaged kidneys

With renal failure the kidneys cannot filter and excrete phosphate efficiently, leading to phosphate retention (hyperphosphatemia).

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