Hypophosphatemia (Hf) is infrequently reported in chronic
hemodialysis patients. The objective of this report is to describe the incidence, etiology, symptoms and treatment of Hf in a Dialysis Unit (defined as
phosphorus < 2.5 mg/dL). In a retrospective study over a period of three years, we identified 22 cases of Hf, occurring on 11 among 149 patients. A two-groups distribution was made: Group A, patients with more than one episode (n = 3, 14 episodes of Hf) and Group B, patients with only one isolated episode of Hf (n = 8, 8 episodes of Hf). Plasma Ca, P,
Albumin and nPCR were significant lower in group A (p < 0.05). Only two patients of group B had symptoms. Cases of Hf were: Group A:
low-protein diet and
alcoholism, Group B: decreased dietary intake due to non-digestive problems (n = 2) or due to digestive problems plus
antacids (n = 4), phos-phate binders (n = 1) and
dietary phosphorus restriction (n = 1). Three patients had
secondary hyperparathyroidism. Treatment consisted on oral supplementarion by diet and changes in oral
calcium salts. Intravenous supplementation was required acutely to raise serum P in a patient with auricular fibrilation. Two group A patients who has plasma 1.25
vitamin D < 5 pg/mL received
vitamin D, and the third oral supplements of P. In all the cases, Hf resolved with these measures. We concluded that Hf is not so infrequent in
hemodialysis. In patients with
low-protein diet and low
vitamin D concentration, Hf can be sustained. On the other hand, a decreased dietary intake maintaining similar
phosphate binder's supplementation is the most frequent cause of occasional and symptomatic Hf, even in patients with
secondary hyperparathyroidism.