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Chapter: Clinical Anesthesiology: Perioperative & Critical Care Medicine: Management of Patients with Fluid & Electrolyte Disturbances

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Hyperphosphatemia

Hyperphosphatemia may be seen with increased phosphorus intake (abuse of phosphate laxatives or excessive potassium phosphate administration), decreased phosphorus excretion (renal insuffi-ciency), or massive cell lysis (following chemother-apy for lymphoma or leukemia).

HYPERPHOSPHATEMIA

 

Hyperphosphatemia may be seen with increased phosphorus intake (abuse of phosphate laxatives or excessive potassium phosphate administration), decreased phosphorus excretion (renal insuffi-ciency), or massive cell lysis (following chemother-apy for lymphoma or leukemia).

Clinical Manifestations of Hyperphosphatemia

Although hyperphosphatemia itself does not appear to be directly responsible for any functional disturbances, its secondary effect on plasma [Ca2+] can be important. Marked hyperphosphatemia is thought to lower plasma [Ca2+] by precipitation and deposition of calcium phosphate in bone and soft tissues.

Treatment of Hyperphosphatemia

 

Hyperphosphatemia is generally treated with phos-phate-binding antacids such as aluminum hydrox-ide or aluminum carbonate.

Anesthetic Considerations

Although specific interactions between hyperphos-phatemia and anesthesia are generally not described, renal function should be carefully evaluated. Sec-ondary hypocalcemia should also be excluded.

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