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Etiology: Reduced renal excretion (e.g., CKD) Increased phosphate load (e.g., phosphate-containing enemas, vitamin D excess) Cellular breakdown (e.g., tumor lysis syndrome) Endocrine disorders (e.g., hypoparathyroidism) Clinical Relevance: Hyperphosphatemia is not merely a laboratory abnormalityit is a key driver of CKD-mineral and bone disorder (CKD-MBD) and is independently associated with increased cardiovascular mortality

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Inadequate protein consumption is another frequent error