Acute Hyperphosphatemia and Acute Persistent Renal Insufficiency Induced by Oral Phosphate Therapy

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Abstract
Intravenous phosphate therapy alone or combined with oral phosphate therapy on occasion has caused metastatic calcification and renal impairment (1). This report documents a case in which oral phosphate therapy alone was associated with acute hyperphosphatemia and acute onset of persistent renal insufficiency. A 64-year-old black man with primary hyperparathyroidism was hospitalized for a neck exploration. Because of symptoms and signs of congestive heart failure and an electrocardiogram that showed changes consistent with a recent myocardial infarction, surgery was postponed. Admission laboratory data included the following: hematocrit, 36.2%; leukocyte count, 5200/mm3; blood urea nitrogen, 16 mg/100 ml (normal, 10 to

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