Hemodialysis for near-fatal sodium phosphate toxicity in a child receiving sodium phosphate enemas.
OBJECTIVE
This study aimed to demonstrate the importance of considering hemodialysis as a treatment option in the management of sodium phosphate toxicity.


METHODS
This is a case report of a 4-year-old who presented to the emergency department with shock, decreased mental status, seizures, and tetany due to sodium phosphate toxicity from sodium phosphate enemas.


RESULTS
Traditional management of hyperphosphatemia with aggressive hydration and diuretics was insufficient to reverse the hemodynamic and neurological abnormalities in this child. This is the first report of the use of hemodialysis in a child without preexisting renal failure for the successful management of near-fatal sodium phosphate toxicity.


CONCLUSIONS
Hemodialysis can safely be used as an adjunctive therapy in sodium phosphate toxicity to rapidly reduce serum phosphate levels and increase serum calcium levels in children not responding to conventional management.
From the *Nephrology Section, †Center for Clinical and Translational Research, The Research Institute, and ‡Critical Care Section, Nationwide Children's Hospital, Columbus, OH.
Brian
B
Becknell
William E
WE
Smoyer
Nicole F
NF
O'Brien
D002675:Child, Preschool; D004638:Emergency Treatment; D004733:Enema; D006801:Humans; D054559:Hyperphosphatemia / Q000139:chemically induced / Q000628:therapy*; D008297:Male; D062025:Organophosphate Poisoning; D010710:Phosphates / Q000009:adverse effects*; D006435:Renal Dialysis
D010710:Phosphates; C018279:sodium phosphate