Hyperphosphataemia and other electrolyte

Q 78 years elderly patient is admitted to ICU after incidental over-ingestion of large amounts of Fleet's Phospho-Soda to relieve constipation, resulting in acute hyperphosphatemia. All other labs were found to be normal on admission. IV saline infusion started. Which one other electrolyte should have been watched closely? - select one

A) Sodium

B) Potassium

C) Calcium

D) Vitamin D

E) Thiamine

Answer: C

Acute severe hуреrрhοsрhаtemiа results in symptomatic hypocalcemia. Phοѕрhаte excretion is increased by saline infusion, but it causes further hypocalcemia by dilution. If no resolution occurs in a few hours or renal function seems to be deteriorating with nephropathy, hemodialysis may be needed.

#nephrology

#electrolytes

#toxicity

References:

1. Zheng WH, Yao Y, Zhou H, Xu Y, Huang HB. Hyperphosphatemia and Outcomes in Critically Ill Patients: A Systematic Review and Meta-Analysis. Front Med (Lausanne). 2022 May 17;9:870637. doi: 10.3389/fmed.2022.870637. PMID: 35665344; PMCID: PMC9156794.

2. Malberti F. Hyperphosphataemia: treatment options. Drugs. 2013 May;73(7):673-88. doi: 10.1007/s40265-013-0054-y. PMID: 23625273.