Hypophosphataemia

Causes

Redistribution (enters cells with insulin / glucose)

• Treatment of Diabetic Ketoacidosis
• Carbohydrate administration after fasting
• Cellular uptake syndrome
• after parathyroidectomy
• Respiratory Alkalosis

Renal Losses

• Primary Hyperparathyroidism
• Renal Tubular Defects
• Diuretics

Decreased intake / absorption

• Dietary
• Malabsorption
• Vomiting
• Phosphate binding agents (aluminium hydroxide)
• Vitamin D deficiency / resistance
• inadequate parenteral nutrition
• alcohol withdrawal

Features

• muscle weakness
  • diaphragmatic weakness
  • decreased cardiac contractility
  • skeletal muscle rhabdomyolysis
• left-shift in oxyhaemoglobin dissociation curve
• haemolysis
• confusion
• hallucinations
• convulsions

Treatment

• administration of phosphate
  • no faster than 9mmol / 12 hours
  • monitor calcium levels

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