Phosphate Enemas Can Cause Hyperphosphatemia
Purgative products introduce 10 times the normal daily amount of phosphorus into the body.
CHICAGO—Sodium phosphate enemas used for bowel cleansing can temporarily boost serum phosphorus levels and promote hyperphosphatemia, according to a study presented at the American Society of Nephrology's 2016 Kidney Week meeting.
Among 22 cases of enema administration at their hospital over 3 months, mild hyperphosphatemia developed in 2 patients, reported Javier Villacorta, PhD, Ana M. Tato, MD, and Gema Fernandez Juarez, PhD, of Hospital Fundacion Alcorcon in Spain. In addition, hypocalcemia developed in 5 patients with previously normal calcium levels. Most received just a single enema containing 8 g sodium phosphate.
Before enema administration, average serum phosphorus and calcium levels were 2.94 and 8.3 mg/dL, respectively. Within 24 hours of enema administration, the mean phosphorus level rose to 3.2 and mean calcium level fell to 8 mg/dL.
In half of cases, a single enema led to phosphorus excesses (0.34 mg/dL on average) and calcium deficits (-0.2 mg/dL). Previous research has shown that oral phosphate solutions likewise increase phosphorus.
“These electrolytes changes are mild and transient in most cases, but may determine the onset of significant hyperphosphatemia or hypocalcemia in a few patients,” Dr Villacorta and colleagues explained. “A higher serum creatinine before enema administration was the main factor associated with the development of electrolyte disturbances.”
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- Villacorta J, Tato AM, and Fernandez Juarez G. Incidence of Hyperphosphatemia and Hypocalcemia Secondary to Phosphate Enema Administration. Presented at: Kidney Week 2016. November 15-20, 2016. Chicago. Abstract TH-PO1145.