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Pathophys and Cause

Cause:Malnutrition; aluminum-binding antacids; iv glucose, which drives intracellularly; renal tubular damage from hypokalemia, osmotic diuresis, or Fanconi’s. In types without cell injury like acute DKA, hyperalimentation, or acute respiratory alkalosis, no bad consequences occur because total body PO4 depletion has not occurred (Nejm 1985;313:447)

Signs and Symptoms

Sx:Confusion, weakness

Complications

Bleeding (impaired platelet function), infections (impaired granulocyte function), rhabdomyolysis

Lab and Xray

Lab: PO4 low

Treatment

Rx: 2.5 mg elemental phosphorus/kg in NS over 12-h iv, or po w NeutroPhos