title: Severe hypocalcaemia and hyperphosphataemia caused by oral sodium phosphate fleet solution in a haemodialysis patient after parathyroidectomy.
abstract: We report a case with severe electrolyte disturbance after the use of oral sodium phosphate solution (OSPS). A 69-year-old patient on haemodialysis received 45 mL of OSPS for bowel preparation. He had symptomatic hypocalcaemia with a serum calcium level of 0.95 mmol/L and serum phosphate level of 4.73 mmol/L. He was treated with haemodialysis and intravenous calcium supplementation. This patient had total parathyroidectomy recently leading to the absence of parathyroid hormone response. OSPS has been reported to cause life-threatening electrolyte disturbance especially in patients with renal failure. We suggest the use of safer alternatives for bowel preparations in renal failure patients.
authors.affiliation: Department of Medicine, Queen Mary Hospital, Hong Kong, China.
authors.forename: Maggie Ming Yee
authors.initials: MM
authors.lastname: Mok
authors.affiliation: Department of Medicine, Queen Mary Hospital, Hong Kong, China.
authors.forename: Terence
authors.initials: T
authors.lastname: Yip
authors.affiliation: Dr Lee Iu Cheung Memorial Renal Research Centre, Tung Wah Hospital, Hong Kong, China.
authors.forename: Sing Leung
authors.initials: SL
authors.lastname: Lui
authors.affiliation: Department of Medicine, Queen Mary Hospital, Hong Kong, China.
authors.forename: Daniel Tak Mao
authors.initials: DT
authors.lastname: Chan
authors.affiliation: Department of Medicine, Queen Mary Hospital, Hong Kong, China.
authors.forename: Kar Neng
authors.initials: KN
authors.lastname: Lai
authors.affiliation: Dr Lee Iu Cheung Memorial Renal Research Centre, Tung Wah Hospital, Hong Kong, China.
authors.forename: Wai Kei
authors.initials: WK
authors.lastname: Lo
keywords: OSPS; haemodialysis; hyperphosphataemia; hypocalcaemia