INS and nutritional deficiency disease: The primary causes of hypophosphatemia include shifting of phosphate into cells (due to insulin, sepsis, respiratory alkalosis), decreased phosphate absorption (due to vitamin D deficiency, malnutrition, alcohol use disorder, iron supplements, bisphosphonates, aluminum-containing agents), and increased phosphate excretion (due to hyperparathyroidism, vitamin D deficiency, oncogenic osteomalacia, steroids, cyclophosphamide, cisplatin, furosemide) [9,10].