Using phosphate supplementation to reverse hypophosphatemia and phosphate depletion in neurological disease and disturbance.

Publisher: Taylor & Francis Country of Publication: England NLM ID: 100892202 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1476-8305 (Electronic) Linking ISSN: 1028415X NLM ISO Abbreviation: Nutr Neurosci Subsets: MEDLINE

Publication: 2016- : Abingdon : Taylor & Francis
Original Publication: [Amsterdam?] : Harwood Academic Publishers : Overseas Publishers Association [distributor], c1998-

Dietary Supplements*/adverse effects; Deficiency Diseases/*diet therapy ; Hypophosphatemia/*diet therapy ; Nervous System Diseases/*physiopathology ; Phosphates/*therapeutic use; Animals ; Deficiency Diseases/diagnosis ; Deficiency Diseases/etiology ; Deficiency Diseases/therapy ; Humans ; Hypophosphatemia/diagnosis ; Hypophosphatemia/physiopathology ; Hypophosphatemia/therapy ; Infusions, Intravenous ; Nervous System Diseases/blood ; Nervous System Diseases/etiology ; Nutritional Status ; Phosphates/administration & dosage ; Phosphates/adverse effects ; Phosphates/deficiency ; Phosphorus/blood ; Practice Guidelines as Topic ; Refeeding Syndrome/blood ; Refeeding Syndrome/etiology ; Refeeding Syndrome/physiopathology ; Refeeding Syndrome/prevention & control ; Severity of Illness Index

Hypophosphatemia (HP) with or without intracellular depletion of inorganic phosphate (Pi) and adenosine triphosphate has been associated with central and peripheral nervous system complications and can be observed in various diseases and conditions related to respiratory alkalosis, alcoholism (alcohol withdrawal), diabetic ketoacidosis, malnutrition, obesity, and parenteral and enteral nutrition. In addition, HP may explain serious muscular, neurological, and haematological disorders and may cause peripheral neuropathy with paresthesias and metabolic encephalopathy, resulting in confusion and seizures. The neuropathy may be improved quickly after proper phosphate replacement. Phosphate depletion has been corrected using potassium-phosphate infusion, a treatment that can restore consciousness. In severe ataxia and tetra paresis, complete recovery can occur after adequate replacement of phosphate. Patients with multiple risk factors, often with a chronic disease and severe HP that contribute to phosphate depletion, are at risk for neurologic alterations. To predict both risk and optimal phosphate replenishment requires assessing the nutritional status and risk for re-feeding hypophosphatemia. The strategy for correcting HP depends on the severity of the underlying disease and the goal for re-establishing a phosphate balance to limit the consequences of phosphate depletion.

Keywords: Hypophosphatemia; Malnutrition; Nervous system; Refeeding syndrome

0 (Phosphates)
27YLU75U4W (Phosphorus)

Date Created: 20150425 Date Completed: 20170310 Latest Revision: 20170310

20231215

10.1179/1476830515Y.0000000024

25909152