Severe hyperphosphatemia in a patient with chronic kidney disease and multiple myeloma–to strengthen the case toward renal replacement therapy?

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Key Clinical Message

We report a patient with multiple myeloma and chronic kidney disease who presented with severe hyperphosphatemia in the outpatient clinic without any related symptoms. Initial differential diagnosis: Tumor lysis syndrome or chronic kidney disease. Further work-up revealed pseudohyperphosphatemia. In general, treatment is not necessary if the true phosphate level is within the reference range and the patient is asymptomatic.

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