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Respiratory illness and hypophosphatemia.

J Fisher, N Magid, C Kallman

    Chest
    |March 1, 1983
    PubMed
    Summary

    Hypophosphatemia, or low serum phosphate, affects 17% of hospitalized patients with pulmonary disease, especially those with respiratory infections. This condition is linked to longer hospital stays but not increased mortality.

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    Area of Science:

    • Pulmonary Medicine
    • Internal Medicine
    • Clinical Chemistry

    Background:

    • Hypophosphatemia (low serum phosphate) is a common electrolyte disturbance.
    • Its prevalence and clinical significance in pulmonary disease patients are not well-defined.

    Purpose of the Study:

    • To determine the prevalence, sequelae, and etiology of hypophosphatemia in hospitalized pulmonary disease patients.
    • To investigate the association between hypophosphatemia and clinical outcomes, including hospital stay and mortality.

    Main Methods:

    • Retrospective chart review of 308 pulmonary disease admissions and 100 general medical admissions.
    • Analysis of serum phosphate levels, clinical symptoms, laboratory findings, and hospital outcomes.

    Main Results:

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    • Overall prevalence of hypophosphatemia (serum phosphate < 2.4 mg/dl) was 17% in pulmonary patients, higher in respiratory infections (28%).
    • Hypophosphatemia on admission was significantly more frequent in respiratory infections (21%) vs. non-infectious respiratory illness or general medical patients (2%).
    • Low phosphate levels were associated with prolonged hospital stays (twice as long) but not increased mortality. Elevated muscle enzymes were a common co-finding.

    Conclusions:

    • Hypophosphatemia is prevalent in hospitalized pulmonary disease patients, particularly those with respiratory infections.
    • Phosphate-binding antacids may exacerbate hypophosphatemia and worsen ventilatory function in susceptible patients.
    • Judicious use of phosphate-binding antacids is recommended in patients with severe respiratory disease.