- Normal phosphate: 2.5-4.5 mg/dl
- Usually caused by diuretics, glucocorticoids, sodium bicardbonate, rapidly refeeding patients, respiratory alkalosis, treatment of diabetic ketoacidosis (phosphate shifts into intracellular space)
- Symptoms: hypoxia, confusion, delirium, seizures, coma, respiratory failure, difficulty breathing, heart failure, arrhythmias
- Supplement IV fluid with 10-30 mmol/L of phosphate in patients at risk.
- Oral products (K-Phos) can be used for asymptomatic patients but are poorly absorbed.
- Symptomatic patients receive 15-30 mmol and sometimes 60 mmol of phosphorus IV over 3-6 hours
Typically in patients with chronic kidney disease or hypoparathyroidism. In general, patients are asymptomatic. See chronic kidney disease for treatment.