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Incidence and aetiology of renal phosphate loss in patients with hypophosphatemia in the intensive care unit.
Intensive Care Med. 2013 Oct; 39(10):1785-91.IC

Abstract

BACKGROUND

Hypophosphatemia is a common finding in patients in the intensive care unit (ICU). Its cause is often poorly understood.

PURPOSE

The aim of this study was to understand the incidence of renal phosphate loss in ICU-related hypophosphatemia, and to examine the role of phosphaturic hormones in its etiology.

METHODS

Plasma phosphate levels were measured on day 1, 3, 5 and 7 in 290 consecutive patients admitted to the ICU. Renal phosphate handling and phosphaturic hormones were studied in a subset of patients with phosphate levels <0.6 mmol/L. Renal phosphate loss was defined as a TmP/gfr < 0.6 mmol/L.

MAIN RESULTS

Hypophosphatemia developed in 24% of all patients. This mainly occurred within the first 3 days of stay and in patients with serum creatinine levels <150 μmol/L. Renal phosphate loss was present in 80% of patients who developed hypophosphatemia, and was not related to serum levels of parathyroid hormone (PTH), PTH-related protein (PTH-rp), fibroblast growth factor 23 (FGF-23), or calcitonin.

CONCLUSION

Hypophosphatemia in the ICU is commonly associated with renal phosphate loss. It mainly occurs within the first 3 days of admission, in particular in patients with preserved renal function. Renal phosphate loss is not explained by elevated PTH, PTH-rp, FGF-23 or calcitonin levels.

Authors+Show Affiliations

Department of Internal Medicine, Rijnstate Hospital, Wagnerlaan 55, 6800 TA, Arnhem, The Netherlands, annekebech@hotmail.com.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

23873336

Citation

Bech, Anneke, et al. "Incidence and Aetiology of Renal Phosphate Loss in Patients With Hypophosphatemia in the Intensive Care Unit." Intensive Care Medicine, vol. 39, no. 10, 2013, pp. 1785-91.
Bech A, Blans M, Telting D, et al. Incidence and aetiology of renal phosphate loss in patients with hypophosphatemia in the intensive care unit. Intensive Care Med. 2013;39(10):1785-91.
Bech, A., Blans, M., Telting, D., & de Boer, H. (2013). Incidence and aetiology of renal phosphate loss in patients with hypophosphatemia in the intensive care unit. Intensive Care Medicine, 39(10), 1785-91. https://doi.org/10.1007/s00134-013-2970-4
Bech A, et al. Incidence and Aetiology of Renal Phosphate Loss in Patients With Hypophosphatemia in the Intensive Care Unit. Intensive Care Med. 2013;39(10):1785-91. PubMed PMID: 23873336.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Incidence and aetiology of renal phosphate loss in patients with hypophosphatemia in the intensive care unit. AU - Bech,Anneke, AU - Blans,Michiel, AU - Telting,Darryl, AU - de Boer,Hans, Y1 - 2013/07/20/ PY - 2013/03/02/received PY - 2013/05/18/accepted PY - 2013/7/23/entrez PY - 2013/7/23/pubmed PY - 2014/5/6/medline SP - 1785 EP - 91 JF - Intensive care medicine JO - Intensive Care Med VL - 39 IS - 10 N2 - BACKGROUND: Hypophosphatemia is a common finding in patients in the intensive care unit (ICU). Its cause is often poorly understood. PURPOSE: The aim of this study was to understand the incidence of renal phosphate loss in ICU-related hypophosphatemia, and to examine the role of phosphaturic hormones in its etiology. METHODS: Plasma phosphate levels were measured on day 1, 3, 5 and 7 in 290 consecutive patients admitted to the ICU. Renal phosphate handling and phosphaturic hormones were studied in a subset of patients with phosphate levels <0.6 mmol/L. Renal phosphate loss was defined as a TmP/gfr < 0.6 mmol/L. MAIN RESULTS: Hypophosphatemia developed in 24% of all patients. This mainly occurred within the first 3 days of stay and in patients with serum creatinine levels <150 μmol/L. Renal phosphate loss was present in 80% of patients who developed hypophosphatemia, and was not related to serum levels of parathyroid hormone (PTH), PTH-related protein (PTH-rp), fibroblast growth factor 23 (FGF-23), or calcitonin. CONCLUSION: Hypophosphatemia in the ICU is commonly associated with renal phosphate loss. It mainly occurs within the first 3 days of admission, in particular in patients with preserved renal function. Renal phosphate loss is not explained by elevated PTH, PTH-rp, FGF-23 or calcitonin levels. SN - 1432-1238 UR - https://www.unboundmedicine.com/medline/citation/23873336/Incidence_and_aetiology_of_renal_phosphate_loss_in_patients_with_hypophosphatemia_in_the_intensive_care_unit_ L2 - https://dx.doi.org/10.1007/s00134-013-2970-4 DB - PRIME DP - Unbound Medicine ER -