Disturbances in Acid-Base Balance During Hypophosphatemia and Phosphate Depletion

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Abstract
It is very difficult to produce appreciable phosphate depletion by simple dietary deprivation. During an 18-day study of normal men and women on a low phosphate diet (1), phosphate virtually disappeared from the urine by the twelfth day, but persistent stool losses resulted in a slight negative balance in both sexes. Nevertheless, serum phosphorus remained normal in men (perhaps because of greater soft tissue breakdown, as evidenced by more extensive potassium losses) but fell in women (where the large calcium losses suggest a skeletal origin). In both men and women, however, the loss of phosphate from the body was small. By contrast, severe hypophosphatemia may eventuate as a result of shifts of phosphate into cells without any appreciable loss from the body. To examine derangements in phosphate metabolism, therefore, a sharp distinction must be made between hypophosphatemia and disturbances in phosphate metabolism which may or may not be associated with it.