Hypophosphatemia in Emergency Medicine Follow-up

Updated: Dec 02, 2016
  • Author: Alex Koyfman, MD; Chief Editor: Erik D Schraga, MD  more...
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Further Inpatient Care

Patients with severe or symptomatic hypophosphatemia should be admitted for IV replacement therapy.

Since isolated phosphate deficiency is extremely unlikely, these patients invariably have a comorbid reason for admission.

Equilibration of IV with intracellular phosphate usually leads to recurrence of hypophosphatemia, making periodic monitoring and replacement necessary over the ensuing 2 days.

A rational approach to IV phosphate replacement is to administer a predefined amount of phosphate, then reevaluate the resulting serum phosphate level every 6 hours to guide further treatment.



The ED physician should be aware of the complications of IV phosphate replacement, including hypocalcemia (tetany) and hyperphosphatemia.

Avoid hyperphosphatemia because it can cause crystal deposition in various tissues (eg, blood vessels, eye, lung, heart, kidney).

Always administer IV phosphate cautiously in patients with renal failure.


Patient Education

Patients and their families should be taught that 1 quart of cow's milk provides the amount of phosphate consumed by the average person in 1 day.