Hypophosphatemia is observed in patients undergoing nocturnal hemodialysis.
Why is that? Phos is usually an intra cellular element. When we do regular 3-4 hours of HD, the extraceullar Phos is removed and the intracellular equilibrates and things are in good balance. When things are prolonged in terms of hours ( for the better) in nocturnal HD, there is actually depletion of Phos( seen also in CVVHDF). Many times, this has to be repleted back to the patient to prevent respiratory complications. Phosphate is commonly added to the dialysate acid bath, but systematic evaluation of the safety and reliability of this strategy is lacking. The study linked below looked at the addition of fleet enema to the solution. They added serial aliquots of enema to 4.5 L of dialysate acid concentrate and proportioned the solution on Gambro and Althin/Baxter dialysis machines for up to 8 hours. Then, the dialysate phosphate, Ca, pH, and bicarbonate concentrations at baseline, and after simulated dialysis at 4 and 8 hours was measured. For every 30 mL of Fleet® (1.38 mmol/mL of phosphate) enema added, the dialysate phosphate concentration increased by 0.2 mmol/L. There were no significant changes in dialysate phosphate, Ca, pH, and bicarbonate concentrations over 8 hours. Bacterial and endotoxin testing met sterility standards. The addition of Fleet enema to dialysate increases phosphate concentration in a concentration prediction as depicted above.
Image source: periodicfun.wikispaces.com
- ► 2019 (33)
- ► 2018 (57)
- ► 2017 (52)
- ► 2016 (45)
- ► 2015 (63)
- ► 2014 (95)
- ► 2013 (133)
- ► 2012 (201)
- Fascinating Wordle in AJT 2011
- NKF 2011 Live Blogging from Nephrology on Demand
- TOPIC DISCUSSION: Vascular Amyloidosis and the Kid...
- NKF 2011 Live Blogging: Integrating the treatment ...
- TOPIC DISCUSSION: TMA ( AJKD tells the tale of 2 d...
- Nephron Animation website
- CONSULT ROUNDS: Renal Involvement in Bardet-Biedl ...
- USA-Nephronpower Wordle( Nephrology Rules)
- Dichotomous Effects of Rapamycin
- TOPIC DISCUSSION: The impact of stopping inhibitor...
- Health News - Research brings new hope of renal re...
- AJP Podcasts
- IN THE NEWS--> Salt sensitive HTN and temperature?...
- TOPIC DISCUSSION: Renal Denervation for Treatment ...
- CONSULT ROUNDS: Pre Eclampsia
- Online CME resource( Nephrology)
- Pediatrics Grand rounds continue
- TOPIC DISCUSSION: Hypophosphatemia in Nocturnal he...
- Journal CLUB: Pediatric Nephrology
- IN THE NEWS--> Statins and the Kidney after surger...
- Arteries and Kidney Transplant
- Pancreas Transplantation in the Treatment of Diabe...
- IN THE NEWS -MDR-1 polymorphisms in steroid resist...
- TOPIC DISCUSSIONS: Glomerular Disease following co...
- May 2011 Hofstra University Kidney Walk
- IN THE NEWS:- RENALASE and CKD
- Transplant Tourism and Malignancy
- IN THE NEWS --->Innovative tools in nephrology su...
- TOPIC DISCUSSION: Rheumatoid Arthritis and the Kid...
- Cystic Diseases of the Kidney: A primer
- CLINICAL CASE 35, ANSWERS AND SUMMARY
- Submit Kidney Week 2011 Abstracts
- IVIG - how does it work from the Immunology blog?
- JOURNAL CLUB: CHOICE STUDY
- IN THE NEWS- ANCA in the Elderly
- Medicine for residents: Calcium gluconate in a dig...
- IN THE NEWS--> Detective Nephron's next venture
- Neutropenia from Tacrolimus
- IN THE NEWS-- Serum Bilirubin and chronic dialysis...
- ▼ April (39)
- ► 2010 (461)