Skip to main content
SpringerLink
Log in

Phosphate and Calcium Disorders

  • Chapter
  • First Online:
Metabolic Disorders and Critically Ill Patients

  • 1751 Accesses

Abstract

Calcium and phosphate metabolisms are closely connected. Body function of calcium is double: the divalent cation form plays a major role in various cell functions. The association of calcium with phosphate induces the formation of hydroxyapatite crystals which provide the rigidity of bones. Independently of bone and calcium, phosphorus exerts several essential cell functions. The ionized form represents the major intracellular buffer. Phosphate and calcium homeostasis is essentially controlled by three hormones (parathormone, vitamin D, and calcitonin) which exert their effect on three targeted organs: bone tissue and intestinal and renal tubular cells. This chapter is focused on body distribution of calcium and phosphorus and their control. Clinical manifestations, diagnosis, and symptomatic treatments of phosphate and calcium disorders are reviewed.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution

Institutional subscriptions

References

  1. Bourdeau JE, Attie MF (1994) Calcium metabolism. In: Narins RG (ed) Clinical disorders of fluid and electrolyte metabolism. McGraw Hill Inc, New York, pp 243–306

    Google Scholar 

  2. Shaker JL, Deftos L (2000) Calcium and phosphate homeostasis. In: De Groot LJ, Beck-Peccoz P, Chrousos G, Chrousos G, Dungan K, Grossman A, Hershman JM, Koch C, McLachlan R, New M, Rebar R, Singer F, Vinik A, Weickert MO (eds) Endotext [internet]. South Darmount (MA): MD Text.com, Inc 2000- update 2014 Apr 11

  3. Blaine J, Chonchol M, Levi M (2015) Renal control of calcium, phosphate, and magnesium homeostasis. Clin J Am Soc Nephrol 10:1257–1272

    Article  CAS  PubMed  Google Scholar 

  4. Taylor JG, Bushinsky DA (2009) Calcium and phosphorus homeostasis. Blood Purif 27:387–394

    Article  CAS  PubMed  Google Scholar 

  5. Goltzman D (2015) Hypercalcemia. In: De Groot LJ, Beck-Peccoz P, Chrousos G, Chrousos G, Dungan K, Grossman A, Hershman JM, Koch C, McLachlan R, New M, Rebar R, Singer F, Vinik A, and Weickert MO (eds) Endotext [internet]. South Darmount (MA). MD Text.com: Inc 2000- update 2015 Apr 12

  6. Diaz de Barbosa G, Guizzardi S, Tolosa de Talamani N (2015) Molecular aspects of intestinal calcium absorption. World J Gastroenterol 21:7142–7154

    Article  CAS  Google Scholar 

  7. Brown EM (2001) Physiology of calcium homeostasis. In: Bilezikian JP, Marcus R, Levine A (eds.). The parathyroids. 2nd ed. Chapter 10: 167–182

    Google Scholar 

  8. Nissenson RA, Juppner H (2013) Parathyroid hormone. In: Rosen CJ ed. Primer on the metabolic bone diseases and disorders of mineral metabolism. 8th ed. Chapter 26: 208–214

    Google Scholar 

  9. Kurakawa K (1994) The kidney and calcium homeostasis. Kidney Int 44:S97–105

    Google Scholar 

  10. Suki WN, Lederer ED, Rouse D (2002) Renal transport of calcium, magnesium, and phosphate. In: Brenner BM (ed) The kidney. Saunders, Philadelphia, pp 520–574

    Google Scholar 

  11. Magyar CE, Friedman PA (2002) Renal regulation of calcium, phosphate and magnesium. In: DuBose TD, Hamm LL (eds) Acid-base and electrolyte disorders: a companion to Brenner’s and Rector’s the kidney. Saunders, Philadelphia, pp 435–452

    Google Scholar 

  12. Mirrakhimov AE (2015) Hypercalcemia of malignancy: an update on pathogenesis and management. N Am J Med Sci 7:483–493

    Article  PubMed  PubMed Central  Google Scholar 

  13. Lee R, Weber TJ (2010) Disorders of phosphorus homeostasis. Curr Opin Endocrinol Diabetes Obes 17:561–571

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  14. Delanaye P, Krzesinski JM (2005) News about phosphorus metabolism. Rev Med Liege 60:1889–1897

    Google Scholar 

  15. Marks J, Debnam ES, Unwin RJ (2010) Phosphate homeostasis and the renal-gastrointestinal axis. Am J Physiol Renal Physiol 299:F285–F296

    Article  CAS  PubMed  Google Scholar 

  16. Razzaque M, Lanske B (2007) The emerging role of the fibroblast growth factor-23-klotho axis in renal regulation of phosphate homeostasis. J Endocrinol 194:1–10

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  17. Murer H, Forster I, Hilfiker H et al (1998) Cellular/molecular control of renal Na/Pi-co-transport. Kidney Int 65(suppl):S2–10

    Article  CAS  Google Scholar 

  18. Prié HD, Urena Torres P, Friedlander G (2009) Fibroblast Growth Factor 23-Klotho: a new axis of phosphate balance. Med Sci 25:489–495

    Google Scholar 

  19. Segawa H, Onitsuka A, Furutani J et al (2009) Npt2a and Npt2c in mice play distinct and synergistic roles in inorganic phosphate metabolism and skeletal development. Am J Physiol Renal Physiol 297:F671–F678

    Article  CAS  PubMed  Google Scholar 

  20. Tomoe Y, Segawa H, Shiozawa K et al (2010) Phosphaturic action of fibroblast growth factor 23 in Npt2 null mice. Am J Physiol Renal Physiol 298:F1341–F1350

    Article  CAS  PubMed  Google Scholar 

  21. Hruska KA (2002) Hypophosphatemia and hyperphosphatemia. In: DuBose TD, Hamm LL (eds) Acid-base and electrolyte disorders: a companion to Brenner’s and Rector’s the kidney. Saunders, Philadelphia, pp 489–512

    Google Scholar 

  22. Biber J (1989) Cellular aspects of proximal tubular phosphate reabsorption. Kidney Int 36:360–365

    Article  CAS  PubMed  Google Scholar 

  23. Bickle D (2014) Vitamin D: production, metabolism, and mechanisms of action. In: De Groot LJ, Beck-Peccoz P, Chrousos G, Chrousos G, Dungan K, Grossman A, Hershman JM, Koch C, McLachlan R, New M, Rebar R, Singer F, Vinik A, and Weickert MO (eds) Endotext [internet]. South Darmount (MA). MD Text.com: Inc 2000- update 2014 Apr 11

  24. Carmeliet G, Dermauw V, Bouillon R (2015) Vitamine D signalling in calcium and bone homeostasis: a delicate balance. Best Practice Res Clin Endocrinol Metab 29:621–631

    Article  CAS  Google Scholar 

  25. Quarles LD (2008) Endocrine functions of bone in mineral metabolism regulation. J Clin Invest 118:3820–3828

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  26. Thakker RV (2015) The calcium-sensing receptor: and its involvement in parathyroid pathology. Ann Endocrinol 76:81–83

    Article  Google Scholar 

  27. Goldner W (2016) Cancer-related hypercalcemia. J Oncol Pract 12:426–432

    Article  PubMed  Google Scholar 

  28. Nakai K, Komaba H, Fukagawa M (2010) New insights into the role of fibroblast growth factor 23 in chronic kidney disease. J Nephrol 23:619–625

    PubMed  Google Scholar 

  29. Ritthaler T, Traebert M, Lötscher M, Biber J, Murer H, Kaissling B (1999) Effects of phosphate intake on dstribution of type I Na/Pi cotransporter mRNA in rat kidney. Kidney Int 55:976–983

    Article  CAS  PubMed  Google Scholar 

  30. Hofbauer LC, Khosla S, Dunstan CR et al (2000) The roles of osteoprotegerin and osteoprotegerin ligand in paracrine regulation of bone resorption. J Bone Miner Res 15:2–12

    Article  CAS  PubMed  Google Scholar 

  31. Steele T, Kolamunnage-Dona R, Downey C, Cheng-Hock T, Welters I (2013) Assessement and clinical course of hypocalcemia in critically illness. Crit Care 17:R106

    Article  PubMed  PubMed Central  Google Scholar 

  32. Iqbal M, Rehmani R, Hijazi M, Abdulaziz A, Kashif S (2011) Hypocalcemia in Saudi intensive care unit. Ann Thor Med 3:57–59

    Google Scholar 

  33. Hastbacka J, Pettila V (2003) Prevalence and predictive value of ionized hypocalcemia among critically ill patients. Acta Anesthesiol Scand 47:1264–1269

    Article  CAS  Google Scholar 

  34. Zivin JR, Gooley T, Zager RA et al (2001) Hypocalcemia: a pervasive metabolic abnormality in the critically ill. Am J Kidney Dis 37:689–698

    Article  CAS  PubMed  Google Scholar 

  35. Zaloga GP (1992) Hypocalcemia in critically il patients. Crit Care Med 20:251–262

    Article  CAS  PubMed  Google Scholar 

  36. Sauter TC, Lindner G, Ahmad SS et al (2015) Calcium disorders in the emergency department: independent risk factors for mortality. PLoS One 10:e0132788

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  37. Egi M, Kim I, Nichol A et al (2011) Ionized calcium concentration and outcome in critically ill patients. Crit Care Med 39:314–321

    Article  CAS  PubMed  Google Scholar 

  38. Kelly A, Levine MA (2013) Hypocalcemia in the critically ill patient. J Intensive Care Med 28:166–177

    Article  PubMed  Google Scholar 

  39. Amrein K, Sourij H, Holl A, Wagner G et al (2011) Short-term effects of high-dose oral vitamin D3 in critically ill vitamin D deficient patients: a randomized, double-blind, placebo- controlled pilot study. Crit Care 15:R104

    Article  PubMed  PubMed Central  Google Scholar 

  40. Akhnoundi A, Sing B, Vela M et al (2015) Incidence of adverse events during continuous renal replacement therapy. Blood Purif 39:339–336

    Google Scholar 

  41. Michels TC, Kelly KM (2013) Parathyroid disorders. Am Fam Physician 88:249–257

    PubMed  Google Scholar 

  42. Schafer AL, Shoback DM (2016) Hypocalcemia: diagnosis and treatment. In: De Groot LJ, Beck-Peccoz P, Chrousos G, Chrousos G, Dungan K, Grossman A, Hershman JM, Koch C, McLachlan R, New M, Rebar R, Singer F, Vinik A, and Weickert MO (eds) Endotext [internet]. South Darmount, MA. MD Text.com: Inc 2000- update 2016 January 3

    Google Scholar 

  43. Hendy GN, Cole DEC, Bastepe M (2011) Hypoparathyroidism and pseudohypoparathyroidism. In: De Groot LJ, Beck-Peccoz P, Chrousos G, Chrousos G, Dungan K, Grossman A, Hershman JM, Koch C, McLachlan R, New M, Rebar R, Singer F, Vinik A, and Weickert MO (eds) Endotext [internet]. South Darmount (MA). MD Text.com: Inc 2000- update 2011 Aug 1

    Google Scholar 

  44. Zaloga GP, Chernow B, Cook D et al (1985) Assessment of calcium homeostasis in the critically ill surgical patient. The diagnosis pitfalls of the Mc-Lean-Hastings nomogram. Ann Surg 202:587–594

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  45. Forster J, Querusio L, Burchard KW et al (1985) Hypercalcemia in critically ill surgical patients. Ann Surg 202:512–518

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  46. Ahmad S, Kuraganti G, Steenkamp D (2015) Hypercalcemic crisis: a clinical review. Am J Med 128:239–245

    Article  CAS  PubMed  Google Scholar 

  47. Yanagawa N, Nakhoul F, Kurokawa K, Lee DBN (1994) Physiology of phosphorus metabolism. In: Narins RG (ed) Clinical disorders of fluid and electrolyte metabolism. Mac Graw Hill, New York, pp 307–372

    Google Scholar 

  48. Gaasbeek A, Meinders AE (2005) Hypophosphatemia: an update on its etiology and treatment. Am J Med 118:1094–1101

    Article  CAS  PubMed  Google Scholar 

  49. Geerse DA, Bindels AJ, Kuiper MA, Roos AN, Spronk PE, Schultz MJ (2010) Treatment of hypophosphatemia in the intensive care unit: a review. Crit Care 14:R147

    Article  PubMed  PubMed Central  Google Scholar 

  50. Amanzadeh J, Reilly RF Jr (2006) Hypophosphatemia: an evidence-based approach to its clinical consequences and management. Nat Clin Pract Nephrol 2:136–148

    Article  CAS  PubMed  Google Scholar 

  51. Cohen J, Kogan A, Sahar G, Lev S, Vidne B, Singer P (2004) Hypophosphatemia following open heart surgery: incidence and consequences. Eur J Cardiothorac Surg 26:306–310

    Article  PubMed  Google Scholar 

  52. Polderman KH, Bloemers FW, Peerdeman SM, Girbes AR (2000) Hypomagnesemia and hypophosphatemia at admission in patients with severe head injury. Crit Care Med 28:2022–2025

    Article  CAS  PubMed  Google Scholar 

  53. Kruse JA, Al-Douahji M, Carlson RW (1992) Hypophosphatemia in critically ill patients: incidence and associations. Crit Care Med 20:s107

    Article  Google Scholar 

  54. Sedlacek M, Schoolwerth AC, Remillard BD (2006) Electrolytes disturbances in the intensive care unit. Sem Dialysis 19:496–501

    Article  Google Scholar 

  55. Bech A, Blanc 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 Med 39:185–191

    Article  CAS  Google Scholar 

  56. Salem RR, Tray K (2005) Hepatic resection-related hypophosphatemia is of renal origin as manifested by isolated hyperphosphaturia. Ann Surg 241:343–348

    Article  PubMed  PubMed Central  Google Scholar 

  57. Marik PE, Bedigian MK (1996) Refeeding hypophosphatemia in critically ill patients in an intensive care unit. A prospective study. Arch Surg 131:1043–1047

    Article  CAS  PubMed  Google Scholar 

  58. Gentile MG, Manna GM (2012) Refeeding hypophosphatemia in malnutrition patients: prevention and treatment. Clin Nutr 31:429

    Article  PubMed  Google Scholar 

  59. Ravenscroft AJ, Valentine JM, Knappett PA (1999) Severe hypophosphatemia and insulin resistance in diabetic ketoacidosis. Anaesthesia 54:198

    Article  CAS  PubMed  Google Scholar 

  60. Shor R, Halabe A, Rishver S et al (2006) Severe hypophosphatemia in sepsis as a mortality predictor. Ann Clin Lab Sci 36:67–72

    PubMed  Google Scholar 

  61. The VA/NIH Acute Renal Failure Trial Network (2008) Intensity of renal support in critically ill patients with acute kidney injury. N Engl J Med 359:7–20

    Article  PubMed Central  Google Scholar 

  62. The Renal Replacement Therapy Study Investigators (2009) Intensity of continuous renal-replacement therapy in critically ill patients. N Engl J Med 361:1627–1638

    Article  Google Scholar 

  63. Fall P, Szerlip HM (2010) Continuous renal replacement therapy: cause and treatment of electrolyte complications. Semin Dial 23:581–585

    Article  PubMed  Google Scholar 

  64. Hoffman M, Zemlin AE, Meyer WP, Erasmus RT (2008) Hypophosphataemia at a large academic hospital in South Africa. J Clin Pathol 61:1104–1107

    Article  Google Scholar 

  65. Singhal PC, Kumar A, Desroches L, Gibbons N, Mattana J (1992) Prevalence and predictors of rhabdomyolysis in patients with hypophosphatemia. Am J Med 92:458–464

    Article  CAS  PubMed  Google Scholar 

  66. Falcone N, Compagnoni A, Meschini C, Perrone C, Nappo A (2004) Central pontine myelinolysis induced by hypophosphatemia following Wernicke’s encephalopthy. Neurol Sci 24:407–410

    Article  CAS  PubMed  Google Scholar 

  67. Schwartz A, Gurman G, Cohen G et al (2002) Association between hypophosphatemia and cardiac arrhythmias in the early stages of sepsis. Eur J Intern Med 13:434

    Article  CAS  PubMed  Google Scholar 

  68. Minisola S, Pepe J, Piemonte S, Cipriani C (2015) The diagnosis and management of hypercalcemia. BMJ 350:h2723

    Article  PubMed  CAS  Google Scholar 

  69. Gravelyn TR, Brophy N, Siegert C, Peters-Golden M (1988) Hypophosphatemia-associated respiratory muscle weakness in a general inpatient population. Am J Med 84:870–876

    Article  CAS  PubMed  Google Scholar 

  70. Kestenbaum B, Sampson JN, Rudser KD et al (2005) Serum phosphate levels and mortality risk among people with chronic kidney disease. J Am Soc Nephrol 16:520–528

    Article  CAS  PubMed  Google Scholar 

  71. Connolly GM, Cunningham R, McNamee PT, Young IS, Maxwell AP (2009) Elevated serum phosphate predicts mortality in renal transplant recipients. Transplantation 87:1040–1044

    Article  CAS  PubMed  Google Scholar 

  72. Dhingra R, Sullivan LM, Fox CS et al (2007) Relations of serum phosphorus and calcium levels to the incidence of cardiovascular disease in the community. Arch Intern Med 167:879–885

    Article  CAS  PubMed  Google Scholar 

  73. Tonelli M, Curhan G, Pfeffer M et al (2009) Relation between alkaline phosphatase, serum phosphate, and all-cause of cardiovascular mortality. Circulation 120:1784–1792

    Article  CAS  PubMed  Google Scholar 

  74. Singer F (2016) Paget’s disease of bone. In: De Groot LJ, Beck-Peccoz P, Chrousos G, Chrousos G, Dungan K, Grossman A, Hershman JM, Koch C, McLachlan R, New M, Rebar R, Singer F, Vinik A, and Weickert MO (eds) Endotext [internet]. South Darmount (MA). MD Text.com: Inc 2000- update 2016 January 8

  75. Levtchenko E, Schoeber J, Jaeken J (2010) Genetic disorders of renal phosphate transport. N Engl J Med 363:2399–2409

    Google Scholar 

  76. Prié D, Friedlander G (2010) Genetic disorders of renal phosphate transport. N Engl J Med 362:2399–2409

    Article  PubMed  Google Scholar 

  77. Prié D, Ravery V, Boccon-Gibod L, Friedlander G (2001) Frequency of renal phosphate leak among with calcium nephrolithiasis. Kidney Int 60:272–276

    Article  PubMed  Google Scholar 

  78. Hendy GN, Canaff L (2016) Calcium-sensing receptor, proinflammatory cytokines and calcium homeostasis. Sem Cell Dev Biol 49:37–43

    Article  CAS  Google Scholar 

  79. Kakava K, Tournis S, Papadakis G et al (2016) Postsurgical hypoparathyroidism: a systematic review. In Vivo 30:171–179

    CAS  PubMed  Google Scholar 

  80. Qazi RA, Martin KJ (2010) Vitamin D in kidney disease: pathophysiology and the utility of treatment. Endocrinol Metab Clin N Am 39:355–363

    Article  CAS  Google Scholar 

  81. Goodman WG (2005) Calcium and phosphorus metabolism in patients who have chronic kidney disease. Med Clin North Am 89:631–647

    Article  CAS  PubMed  Google Scholar 

  82. London G, Coyne D, Hruska K, Malluche HH, Martin KJ (2010) The new kidney disease: improving global outcomes (KDIGO) guidelines - expert clinical focus on bone and vascular calcification. Clin Nephrol 74:423–432

    CAS  PubMed  PubMed Central  Google Scholar 

  83. Spasovski G, Massy Z, Vanholder R (2009) Phosphate metabolism in chronic kidney disease: from pathophysiology to clinical management. Semin Dial 22:357–362

    Article  PubMed  Google Scholar 

  84. Covic A, Kothawala P, Bernal M, Robbins S, Challan A, Goldsmith D (2009) Systematic review of the evidence underlying the association between mineral metabolism disturbances and risk of all-cause mortality, cardiovascular mortality and cardiovascular events in chronic kidney disease. Nephrol Dial Transplant 24:1506–1523

    Article  PubMed  Google Scholar 

  85. Gutierrez OM, Januzzi JL, Isakowa T et al (2009) Fibroblast growth factor 23 and left ventricular hypertrophy in chronic kidney disease. Circulation 119:2545–2552

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  86. Parker BD, Schugers LJ, Brandenburg VM et al (2010) The associations of fibroblast growth factor 23 and uncarboxylated matrix Gia protein with mortality in coronary artery disease: the heart and soul study. Ann Intern Med 152:640–648

    Article  PubMed  PubMed Central  Google Scholar 

  87. Felsenfeld AJ, Levine BS, Rodriguez M (2015) Pathophysiology of calcium, phosphorus and magnesium dysregulation in chronic kidney disease. Semin Dial 28:564–577

    Article  PubMed  Google Scholar 

  88. Gutierrez OM, Mannstadt M, Isakova T et al (2008) Fibroblast growth factor 23 and mortality among patients undergoing hemodialysis. N Engl J Med 359:584–592

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  89. Jean G, Terrat JC, Vanel T et al (2009) High levels of serum fibroblast growth factor (FGF)-23 are associated with increased mortality in long haemodialysis patients. Nephrol Dial Transplant 24:2792–2797

    Article  CAS  PubMed  Google Scholar 

  90. Moe S, Drüeke T, Cunningham J, Goodman W et al (2006) Definition, evaluation and classification of renal osteodystrophy: a position statement from Kidney Disease: Improving Global Outcomes (KDIGO). Kidney Int 69:1945–1953

    Article  CAS  PubMed  Google Scholar 

  91. Mason MA, Shepler BM (2010) Evaluation of morbidity and mortality data related to cardiovascular calcification from calcium-containing phosphate binder use in patients undergoing hemodialysis. Pharmacotherapy 30:741–748

    Article  CAS  PubMed  Google Scholar 

  92. Wilson FP, Berns JS (2014) Tumor lysis syndrome: new challenges and recent advances. Adv Chronic Kidney Dis 21:18–26

    Article  PubMed  PubMed Central  Google Scholar 

  93. Higaki M, Tanemoto M, Shiraishi T, Taniguchi K, Fujigaki Y, Uchida S (2015) Acute kidney injury facilitates hypocalcemia by exacerbating the hyperphosphatemic effect of muscle damage in rhabdomyolysis. Nephron 131:11–16

    Article  CAS  PubMed  Google Scholar 

  94. Byrnes MC, Stangenes J (2011) Refeeding in the ICU: an adult and pediatric problem. Curr Opin Clin Nutr Metab Care 14:186–192

    Article  PubMed  Google Scholar 

  95. Mehanna HM, Moledina J, Travis J (2008) Refeeding syndrome: what it is, and how to prevent and treat it. BMJ 336:1495–1498

    Article  PubMed  PubMed Central  Google Scholar 

  96. Marinella MA (2005) Refeeding syndrome and hypophosphatemia. J Intensive Care Med 20:155–159

    Article  PubMed  Google Scholar 

  97. Nutrition Support in Adults: oral nutrition support, enteral tube feeding and parenteral nutrition; Clinical guidelines CG32; National Institute for Health and Clinical Excellence: London, UK, 2006

    Google Scholar 

  98. Morabito S, Pistolesi V, Tritapepe L et al (2013) Continuous venovenous hemodiafiltration with a low citrate dose regional anticoagulation protocol and a phosphate-containing solution: effects on acid-base status and phosphate supplementation needs. BMC Nephrol 14:232

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  99. Maier JD, Levine SN (2015) Hypercalcemia in the intensive care unit: a review of pathophysiology, diagnosis, and modern therapy. J Intensive Care Med 30:235–252

    Article  PubMed  Google Scholar 

  100. Aberegg SK (2016) Ionized calcium in the ICU: should it be measured and corrected? Chest 149:846–855

    Article  PubMed  Google Scholar 

  101. Forsythe RM, Wessel CB, Billiar TR, Angus DC, Rosengart MR (2008) Parenteral calcium for intensive care unit patients. Cochrane Database Syst Rev 5:CD006163

    Google Scholar 

  102. Melamed ML, Buttar RS, Coco M (2016) CKD-mineral bone disorder in stage 4 and 5 CKD: what we know today? Adv Chronic Kidney Dis 23:262–269

    Article  PubMed  PubMed Central  Google Scholar 

  103. Tonelli M, Pannu N, Manns B (2010) Oral phosphate binders in patients with kidney failure. N Engl J Med 362:1312–1324

    Article  CAS  PubMed  Google Scholar 

  104. Kandula P, Dobre M, Schold JD, Schreiber MJ Jr, Mehrotra R, Navaneethan SD (2010) Vitamin D suplementation in chronic kidney disease: a systematic review and meta-analysis of observational studies and randomized controlled trials. Clin J Am Soc Nephrol 6:50–62

    Article  PubMed  CAS  Google Scholar 

  105. Navaneethan SD, Palmer SC, Craig JC, Elder GJ, Strippoli GF (2009) Benefits and harms of phosphate binders in CKD: a systematic review of randomized controlled trials. Am J Kidney Dis 54:619–637

    Article  CAS  PubMed  Google Scholar 

  106. Kraft MD, Btaiche IF, Sacks GS, Kudsk KA (2005) Treatment of electrolytes disorders in adult patients in the intensive care unit. Am J Health Syst Pharm 62:1663–1682

    Article  CAS  PubMed  Google Scholar 

  107. Brown KA, Dickerson RN, Morgan LM, Alexander KH, Minard G, Brown RO (2006) A new graduated dosing regimen for phosphorus replacement in patients receiving nutrition support. J Parenter Enter Nutr 30:209–214

    Article  CAS  Google Scholar 

  108. Taylor BE, Huey WY, Buchman TG, Boyle WA, Coopersmith CM (2004) Treatment of hypophosphatemia using a protocol based on patient weight and serum phosphorus level in a surgical intensive care unit. J Am Coll Surg 198:198–204

    Article  PubMed  Google Scholar 

  109. Charron T, Bernard F, Shrobik Y, Simoneau N, Gagnon N, Leblanc M (2003) Intravenous phosphate in the intensive care unit: more aggressive repletion regimens for moderate and severe hypophosphatemia. Intensive Care Med 29:1273–1278

    Article  PubMed  Google Scholar 

  110. Bech A, Blans M, Raaijmakers M, Mulkens C, Telting D, de Boer H (2013) Hypophosphatemia on the intensive care unit: individualized phosphate replacement based on serum levels and distribution volume. J Crit Care 28:838–843

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Intensive Care Unit, Pasteur 2 Hospital, 30 Voie Romaine, 06001, Nice, Cédex 1, France

    Carole Ichai

  2. IRCAN (INSERM U1081, CNRS UMR 7284), University Hospital of Nice, Nice, France

    Carole Ichai

Authors
  1. Carole Ichai
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Carole Ichai .

Editor information

Editors and Affiliations

  1. Intensive Care Unit, Hôpital Pasteur 2, Centre Hospitalier Universitaire de Nice, Université Côte d’Azur, Nice, France

    Carole Ichai

  2. Intensive Care Unit, Hôpital Pasteur 2, Centre Hospitalier Universitaire de Nice, Université Côte d’Azur, Nice, France

    Hervé Quintard

  3. Intensive Care Unit, Hôpital Pasteur 2, Centre Hospitalier Universitaire de Nice, Université Côte d’Azur, Nice, France

    Jean-Christophe Orban

Rights and permissions

Reprints and permissions

Copyright information

© 2018 Springer International Publishing AG

About this chapter

Cite this chapter

Ichai, C. (2018). Phosphate and Calcium Disorders. In: Ichai, C., Quintard, H., Orban, JC. (eds) Metabolic Disorders and Critically Ill Patients. Springer, Cham. https://doi.org/10.1007/978-3-319-64010-5_4

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-64010-5_4

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-64008-2

  • Online ISBN: 978-3-319-64010-5

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation