title: Management of hypophosphatemia induced by high-flux hemodiafiltration for the treatment of vancomycin toxicity: intravenous phosphorus therapy versus use of a phosphorus-enriched dialysate.
abstract: 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.
authors.affiliation: Department of Medicine, Veterans Affairs Hospital, Hines, IL 60141, USA.
authors.forename: R A
authors.initials: RA
authors.lastname: Gatchalian
authors.forename: A
authors.initials: A
authors.lastname: Popli
authors.forename: A A
authors.initials: AA
authors.lastname: Ejaz
authors.forename: D J
authors.initials: DJ
authors.lastname: Leehey
authors.forename: C M
authors.initials: CM
authors.lastname: Kjellstrand
authors.forename: T S
authors.initials: TS
authors.lastname: Ing
mesh_terms: 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
chemical_list: D000900:Anti-Bacterial Agents; D015314:Dialysis Solutions; D010758:Phosphorus; D014640:Vancomycin