Reference:
Hypophosphatemia postintravenous iron is frequent but under-recognized. If prolonged or recurrent, it can cause osteomalacia. The likely mechanisms are direct toxicity to proximal tubular cells causing phosphate wasting, elevated Fibroblast growth factor-23 (FGF-23), and reduced 1,25-dihydroxyvitamin D (1,25(OH)2D). Hypophosphatemia may be severe and persist for months, necessitating phosphate replacement until normalization of serum levels occurs.
Reference:Nataatmadja, M.S. and Francis, R. (2020) Recurrent severe hypophosphatemia following intravenous iron administration. Clinical Case Reports. 8(2), p.243-246. doi: 10.1002/ccr3.2595. eCollection.