Hypophosphataemia

1) Decreased intake

    • Malnutrition

      2) Decreased GI absorption

      3) Increased excretion

      • Renal loss (decreased reabsorption)
        • Increased PTH
        • Myeloma
        • Fanconi syndrome
        • ARF diuretic phase
        • Cisplatin
        • Post obstructive diuresis
      • Hyperparathyroidism (PTH decreases phosphate reabsorption)
      • Malignancy

        4) Acute intracellular shifting of phosphate (To intracellular)

          • Acute leukaemia (taken up by new cells)
          • Post parathyroidectomy
            • Hungry bone syndrome
            • Large deposition of Calcium and phosphate in bone
          • Respiratory alkalosis

            Clinical manifestations

            Diverse effects range from irritability to coma and may lead to

            • Respiratory failure
            • Cardiac failure
            • Rhabdomyolysis
            • Ileus
            • Impaired phagocytosis
            • Haemolysis
            • Thrombocytopenia
            • Metabolic encephalopathy

            Correction

            Oral is safest. Remember calcium supplementation to prevent hypocalcaemia

            • Oral – skim milk 1mg elemental phosphorus per ml
            • IV – 2.5mg/kg over 6 hours
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