Management of hypophosphatemia induced by high-flux hemodiafiltration for the treatment of vancomycin toxicity: intravenous phosphorus therapy versus use of a phosphorus-enriched dialysate.
Intensive high-flux hemodiafiltration is often used in the management of vancomycin toxicity. We describe two patients who developed hypophosphatemia as a consequence of this form of therapy. The first patient was treated with an intravenous phosphorus infusion. For the second patient, hypophosphatemia was corrected, during hemodiafiltration, with the use of a phosphorus-enriched dialysate. The latter dialysate was prepared by adding sodium phosphate salts to the "base concentrate" of a dual-concentrate, bicarbonate-based dialysate delivery system. This simple method was more efficient than intravenous therapy in ameliorating the hypophosphatemia secondary to aggressive hemodiafiltration treatment.
Gatchalian
R A
RA
Department of Medicine, Veterans Affairs Hospital, Hines, IL 60141, USA.
Popli
A
A
Ejaz
A A
AA
Leehey
D J
DJ
Kjellstrand
C M
CM
Ing
T S
TS
D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000506:poisoning* / Q000627:therapeutic use; D015314:Dialysis Solutions / Q000008:administration & dosage*; D062787:Drug Overdose / Q000628:therapy; D017583:Hemodiafiltration / Q000009:adverse effects*; D006801:Humans; D017674:Hypophosphatemia / Q000188:drug therapy / Q000209:etiology / Q000628:therapy*; D007262:Infusions, Intravenous; D008297:Male; D016106:Methicillin Resistance; D010758:Phosphorus / Q000008:administration & dosage / Q000627:therapeutic use*; D013203:Staphylococcal Infections / Q000188:drug therapy; D014640:Vancomycin / Q000506:poisoning* / Q000627:therapeutic use
D000900:Anti-Bacterial Agents; D015314:Dialysis Solutions; D010758:Phosphorus; D014640:Vancomycin