title: Profound hypophosphatemia in the course of acute renal failure.
abstract: Four of 19 patients with acute renal failure (ARF) requiring dialytic therapy were hypophosphatemic (serum phosphate, 0.8 +/- 0.8 mg/dL) during their illness. The hypophosphatemia could not be attributed to differences in the etiology of renal failure, frequency of dialysis, or residual renal function. No hypophosphatemic patient received phosphate-binding antacids. The hypophosphatemia was related to carbohydrate (CHO) providing a large percentage (greater than 79%) of total calories for a prolonged period. This complication was likely caused by tissue anabolism as well as by CHO-stimulated, insulin-induced intracellular shifts of phosphate. The greater use of parenteral fat as a caloric source and more aggressive phosphate supplementation despite the presence of ARF may help prevent this complication.
mesh_terms: D058186:Acute Kidney Injury / Q000097:blood* / Q000401:mortality / Q000628:therapy; D000328:Adult; D000368:Aged; D004040:Dietary Carbohydrates / Q000008:administration & dosage*; D002149:Energy Intake; D004750:Enteral Nutrition; D006801:Humans; D008875:Middle Aged; D010289:Parenteral Nutrition, Total / Q000009:adverse effects*; D010710:Phosphates / Q000008:administration & dosage / Q000097:blood*; D006435:Renal Dialysis
chemical_list: D004040:Dietary Carbohydrates; D010710:Phosphates