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Hypophosphatemia and rhabdomyolysis
The Journal of Clinical Investigation
|December 1, 1978
Summary
Severe hypophosphatemia can trigger rhabdomyolysis in dogs with subclinical myopathy. Providing phosphorus during refeeding prevents these adverse effects, highlighting phosphorus
Area of Science:
- Biochemistry
- Muscle Physiology
- Nutritional Science
Background:
- Clinical observations link severe hypophosphatemia with overt rhabdomyolysis in pre-existing subclinical myopathies.
- Subclinical alcoholic myopathy shows similar cellular changes to phosphorus and calorie deprivation in muscle tissue.
Purpose of the Study:
- To investigate if acute, severe hypophosphatemia can induce overt rhabdomyolysis in animals with diet-induced subclinical myopathy.
- To determine the role of phosphorus supplementation during refeeding in preventing hypophosphatemia-induced myopathy.
Main Methods:
- Subclinical myopathy induced in 23 dogs via phosphorus and calorie deficiency, leading to 30% weight loss.
- Acute hypophosphatemia induced in 17 dogs by refeeding with a phosphorus-deficient diet and carbohydrate supplement (140 kcal/kg/day).
- Control group (6 dogs) received phosphorus supplementation during refeeding.
Main Results:
- Refed dogs without phosphorus supplementation developed weakness, seizures, severe hypophosphatemia (0.8 mg/dl), elevated creatine phosphokinase (CPK), and frank rhabdomyolysis.
- Muscle phosphorus content decreased significantly, with increased muscle sodium, chloride, and water content.
- Dogs receiving phosphorus supplementation during refeeding remained asymptomatic, with normal CPK levels and corrected cellular imbalances.
Conclusions:
- A pre-existing subclinical myopathy creates a vulnerability to rhabdomyolysis when severe hypophosphatemia is superimposed.
- Adequate phosphorus supply during hyperalimentation is crucial for preventing both hypophosphatemia and rhabdomyolysis.
- These findings support the hypothesis that hypophosphatemia is a critical factor in the development of rhabdomyolysis in susceptible individuals.
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