Phosphate Imbalance Flashcards
What are the indications of phosphate?
Treatment of moderate to severe hypophosphatemia
Established hypophosphataemia
Vitamin D resistant hypophosphataemic osteomalacia
When may phosphate deficiency arise?
In patients with
- alcohol dependance
- Severe DKA
- Patients on TPN
However phosphate replacement is not routinely recommended
What are the signs of hyperphosphataemia on an ECG?
Similar to low calcium:
- Prolonged ST and QT interval
- Ventricular tachycardia
What are the signs of hyperphosphataemia in the respiratory system?
Like low calcium:
- soft tissue calcification in lungs
What are the signs of hyperphosphataemia in the neuro system?
Like low calcium:
- Altered level of consciousness
- -> Confusion
- -> can lead to seizures
What are the signs of hyperphosphataemia in the GI system?
Like low calcium:
- Diarrhoea
- Nausea
What are the signs of hyperphosphataemia in the MSK system?
Like low calcium:
- Muscle weakness
- Hyperactive reflexes
What are two classic symptoms in Hyperphosphataemia that are also in hypocalcaemia?
Trousseau’s sign
Chvostek’s sign
What is the first line phosphate binder in the management of hyperphosphataemia in patients with stage 4 or 5 CKD?
Calcium acetate in addition to dietary management.
Calcium carbonate is an alternative.
What non calcium based phosphate binders can be used in the treatment of hyperphosphataemia? (4)
Sevelamer
Lanthanum
Sucroferric oxyhydroxides
