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Severe Hyperphosphatemia in a Patient with Mild Acute Kidney Injury
Phuong Chi Pham1, Raghu Konanur Ventakaram1, Jimmy Pham1
1Olive View-UCLA Medical Center, Division of Nephrology, Sylmar, CA, USA.
Case Reports in Medicine
|May 28, 2021
Summary
Pseudohyperphosphatemia, often mistaken for kidney injury-related hyperphosphatemia, can occur with liposomal amphotericin use. Correctly identifying this condition is crucial, especially in pregnant patients, to avoid detrimental treatments.
Area of Science:
- Nephrology
- Clinical Chemistry
- Infectious Diseases
Background:
- Hyperphosphatemia presents a diagnostic challenge, stemming from diverse causes like kidney dysfunction, cell lysis, or hormonal imbalances.
- Accurate differentiation between true hyperphosphatemia and pseudohyperphosphatemia is critical for appropriate patient management.
Observation:
- A pregnant patient with mucormycosis, treated with liposomal amphotericin, exhibited severe hyperphosphatemia disproportionate to mild acute kidney injury.
- Initial management focused on presumed acute kidney injury-associated hyperphosphatemia with phosphate binders.
Findings:
- Renal consultation revealed the hyperphosphatemia was pseudohyperphosphatemia, directly linked to liposomal amphotericin administration.
- This highlights a potential diagnostic pitfall where medication interferes with laboratory phosphate measurements.
Implications:
- Misdiagnosis and inappropriate treatment of pseudohyperphosphatemia can pose risks, particularly in vulnerable populations like pregnant women.
- Awareness of drug-induced pseudohyperphosphatemia is essential for clinicians to ensure accurate diagnosis and safe therapeutic strategies.
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