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Disorders of phosphate in the critically ill 

Disorders of phosphate in the critically ill
Chapter:
Disorders of phosphate in the critically ill
Author(s):

Daniël A. Geerse

and Marcus J. Schultz

DOI:
10.1093/med/9780199600830.003.0254
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date: 20 February 2020

Phosphorus plays an important role in many cellular processes and hypophosphataemia can result from a number of causes. Critically-ill patients are at increased risk for developing hypophosphataemia due to the presence of multiple causal factors. Hypophosphataemia may lead to a multitude of symptoms and frequent monitoring of serum phosphate is advised in critically-ill patients is recommended and should be corrected in patients with associated symptoms. It is uncertain whether correction in apparently asymptomatic patients affects outcome, although treatment is generally recommended for severe hypophosphataemia. Multiple strategies of intravenous phosphate administration have been described, but it is unknown which strategy is superior. Hyperphosphataemia is most often caused by renal insufficiency, but can also be caused by increased intake or release from damaged cells. Symptoms are mainly associated with subsequent hypocalcaemia and correction of hyperphosphataemia can be achieved by minimizing the intake of phosphate, increasing renal phosphate excretion, and renal replacement therapy.

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