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Diagnosis and Treatment |

Treatment of Severe Hypophosphatemia

[+] Article, Author, and Disclosure Information

Grant support: in part by U.S. Public Health Service Grants HL06314 and AI10704 and Training Grant AM08087.

▸Requests for reprints should be addressed to Carl M. Kjellstrand, M.D.; Department of Medicine, University of Minnesota Hospitals, Minneapolis, MN 55455.

Minneapolis, Minnesota

©1978 American College of PhysiciansAmerican College of Physicians

Ann Intern Med. 1978;89(6):941-944. doi:10.7326/0003-4819-89-6-941
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Aspects of phosphate biochemistry pertinent to therapy, the distribution of phosphorus in body compartments, therapeutic phosphorus preparations, prevention of hypophosphatemia, therapeutic guidelines, and side-effects of phosphorus therapy are reviewed. Severe hypophosphatemia (< 0.32 mmol/litre or < 1 mg/dl) can occur with normal or depleted body stores. Because a large amount of phosphorus may shift rapidly between the extracellular and intracellular or bone compartments, the size of a possible total body deficit cannot be estimated from the serum phosphorus level. Similar shifts may occur unpredictably during repair of hypophosphatemia. Therefore, correction of hypophosphatemia in any patient must be empiric and the response of serum levels to therapy should be followed closely. We discuss a method likely to correct hypophosphatemia while minimizing side-effects.





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