Hypophosphatemia is a common but often underestimated electrolyte derangement among intensive care unit (ICU) patients. Low phosphate levels can lead to cellular dysfunction with potentially relevant clinical manifestations (e.g., muscle weakness, respiratory failure, lethargy, confusion, arrhythmias). In critically ill patients with severe acute kidney injury (AKI) renal replacement therapies (RRTs) represent a well-known risk factor for hypophosphatemia, especially if the most intensive and prolonged modalities of RRT, such as continuous RRT or prolonged intermittent RRT, are used. Currently, no evidence-based specific guidelines are available for the treatment of hypophosphatemia in the critically ill; however, considering the potentially negative impact of hypophosphatemia on morbidity and mortality, strategies aimed at reducing its incidence and severity should be timely implemented in the ICUs. In the clinical setting of critically ill patients on RRT, the most appropriate strategy could be to anticipate the onset of RRT-related hypophosphatemia by implementing the use of phosphate-containing solutions for RRT through specifically designed protocols. The present review is aimed at summarizing the most relevant evidence concerning epidemiology, prognostic impact, prevention and treatment of hypophosphatemia in critically ill patients with AKI on RRT, with a specific focus on RRT-induced hypophosphatemia.

Hypophosphatemia in critically ill patients with acute kidney injury on renal replacement therapies / Pistolesi, V.; Zeppilli, L.; Fiaccadori, E.; Regolisti, G.; Tritapepe, L.; Morabito, S.. - In: JN. JOURNAL OF NEPHROLOGY. - ISSN 1121-8428. - 32:6(2019), pp. 895-908. [10.1007/s40620-019-00648-5]

Hypophosphatemia in critically ill patients with acute kidney injury on renal replacement therapies

Pistolesi V.
;
Zeppilli L.;Tritapepe L.;Morabito S.
2019

Abstract

Hypophosphatemia is a common but often underestimated electrolyte derangement among intensive care unit (ICU) patients. Low phosphate levels can lead to cellular dysfunction with potentially relevant clinical manifestations (e.g., muscle weakness, respiratory failure, lethargy, confusion, arrhythmias). In critically ill patients with severe acute kidney injury (AKI) renal replacement therapies (RRTs) represent a well-known risk factor for hypophosphatemia, especially if the most intensive and prolonged modalities of RRT, such as continuous RRT or prolonged intermittent RRT, are used. Currently, no evidence-based specific guidelines are available for the treatment of hypophosphatemia in the critically ill; however, considering the potentially negative impact of hypophosphatemia on morbidity and mortality, strategies aimed at reducing its incidence and severity should be timely implemented in the ICUs. In the clinical setting of critically ill patients on RRT, the most appropriate strategy could be to anticipate the onset of RRT-related hypophosphatemia by implementing the use of phosphate-containing solutions for RRT through specifically designed protocols. The present review is aimed at summarizing the most relevant evidence concerning epidemiology, prognostic impact, prevention and treatment of hypophosphatemia in critically ill patients with AKI on RRT, with a specific focus on RRT-induced hypophosphatemia.
2019
acute kidney injury; critically ill patients; CRRT; hypophosphatemia; phosphate-containing solutions; RRT
01 Pubblicazione su rivista::01g Articolo di rassegna (Review)
Hypophosphatemia in critically ill patients with acute kidney injury on renal replacement therapies / Pistolesi, V.; Zeppilli, L.; Fiaccadori, E.; Regolisti, G.; Tritapepe, L.; Morabito, S.. - In: JN. JOURNAL OF NEPHROLOGY. - ISSN 1121-8428. - 32:6(2019), pp. 895-908. [10.1007/s40620-019-00648-5]
File allegati a questo prodotto
File Dimensione Formato  
Pistolesi_Hypophosphatemia_2019.pdf

solo gestori archivio

Tipologia: Versione editoriale (versione pubblicata con il layout dell'editore)
Licenza: Tutti i diritti riservati (All rights reserved)
Dimensione 2.56 MB
Formato Adobe PDF
2.56 MB Adobe PDF   Contatta l'autore

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/1341918
Citazioni
  • ???jsp.display-item.citation.pmc??? 5
  • Scopus 36
  • ???jsp.display-item.citation.isi??? 31
social impact