Hypophosphatemia and refeeding: a corrective or a preventive attitude?
Hypophosphatemia is a rare but potentially lethal complication of the refeeding of cachectic patients. Up until now a careful monitoring of the serum phosphor level was recommended and the deficit was corrected as needed. Illustrated by two case reports we propose the use of a preventive schedule in patients with a normal renal function. We show that preventively treated patients do not develop hypophosphatemia and thereby avoid serious complications such as sudden death. In the presence of normal kidney function we propose to administer phosphor at 2 x 10 mmol/day orally or between 10 and 30 mmol IV depending on the initial phosphor levels. Further treatment is then adapted to measured levels. In the presence of kidney malfunction we propose to keep the corrective schedule.
De Cock
A
A
Department of internal medicine, Academical Hospital, AZ-VUB, Brussels.
Mana
F
F
Velkeniers
B
B
Urbain
D
D
D000328:Adult; D000856:Anorexia Nervosa / Q000150:complications* / Q000628:therapy; D004750:Enteral Nutrition; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D017674:Hypophosphatemia / Q000097:blood / Q000209:etiology* / Q000517:prevention & control; D018529:Nutritional Support; D010758:Phosphorus / Q000097:blood / Q000627:therapeutic use*; D011379:Prognosis
D010758:Phosphorus