title: Phoxilium vs Hemosol-B0 for continuous renal replacement therapy in acute kidney injury.
abstract: OBJECTIVE
  This study aimed to compare the biochemical effects of Phoxilium (containing phosphate at 1.2 mmol/L; Gambro Lundia AB, Lund, Sweden) and Hemosol-B0 (Gambro Lundia AB) as dialysate and/or replacement fluid during continuous renal replacement therapy (CRRT).
  
  
  METHODS
  We examined serum biochemistry in critically ill patients for 42 hours of Phoxilium administration for the prevention of hypophosphatemia during CRRT and compared them with corresponding results in random historical controls who received Hemosol-B0.
  
  
  RESULTS
  We studied 15 patients in each arm (Phoxilium vs Hemosol-B0). Respective median ages were 57 (49-68) and 64 (57-67) years. Baseline patient illness severity scores, prescribed CRRT effluent rates, and cumulative phosphate intakes were comparable. After 36 to 42 hours of Phoxilium administration, serum phosphate levels increased from 0.95 (0.81-1.13) to 1.44 (1.23-1.78) mmol/L, in contrast to the decline from 1.71 (1.09-2.00) to 0.83 (0.55-1.59) mmol/L with Hemosol-B0 (P=.0001). Serum ionized calcium levels decreased from 1.27 (1.22-1.37) to 1.12 (1.06-1.21) mmol/L with Phoxilium, compared with an increase from 1.09 (0.90-1.19) to 1.20 (1.16-1.25) mmol/L with Hemosol-B0 (P<.0001). Serum bicarbonate, base excess levels, and effective strong ion difference decreased with Phoxilium and were lower than those with Hemosol-B0 at 36 to 42 hours (P<.05).
  
  
  CONCLUSIONS
  Phoxilium effectively prevented hypophosphatemia during CRRT but was associated with relative metabolic acidosis and hypocalcemia compared with Hemosol-B0 use.
authors.affiliation: Department of Intensive Care, Austin Hospital, Melbourne, Australia; Division of Nephrology, University Medicine Cluster, National University Hospital, National University Health System, Singapore.
authors.forename: Horng-Ruey
authors.initials: HR
authors.lastname: Chua
authors.forename: Antoine G
authors.initials: AG
authors.lastname: Schneider
authors.forename: Ian
authors.initials: I
authors.lastname: Baldwin
authors.forename: Allison
authors.initials: A
authors.lastname: Collins
authors.forename: Lisa
authors.initials: L
authors.lastname: Ho
authors.forename: Rinaldo
authors.initials: R
authors.lastname: Bellomo
mesh_terms: D058186:Acute Kidney Injury / Q000628:therapy*; D000368:Aged; D001802:Blood Substitutes / Q000627:therapeutic use*; D016022:Case-Control Studies; D016638:Critical Illness; D015314:Dialysis Solutions / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D017674:Hypophosphatemia / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D010710:Phosphates / Q000627:therapeutic use*; D017582:Renal Replacement Therapy / Q000379:methods*; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D001802:Blood Substitutes; D015314:Dialysis Solutions; D010710:Phosphates
keywords: Acid-base balance; Acute kidney injury; Continuous renal replacement therapy; Critical illness; Electrolyte abnormalities; Hemosol-B0; Hyperphosphatemia; Hypocalcemia; Hypophosphatemia; Metabolic acidosis; Nutrition; Phosphate-containing solution; Phoxilium