Electrolytic Abnormalities Related to Phosphate in Critically Ill Cancer Patients
Phosphate plays a critical role in physiological processes such as mitochondrial respiration, cellular metabolism, and energy production (glycolysis, gluconeogenesis, and ammoniagenesis). It is also a significant constituent of cell membranes in the form of phospholipids. Hyperphosphatemia and hypophosphatemia are common electrolyte disorders in critically ill patients because of several factors. Both are associated with higher mortality in the ICU. However, most patients remain asymptomatic or do not receive an early management due to serum phosphate that is not routinely measured in ICU. Critically ill patients with cancer have a high risk of phosphate abnormalities because of chemotherapeutical drugs, surgery, tumor-related complications (tumor lysis syndrome), or comorbidities such as renal insufficiency, acid-base balance disorders, and intestinal malabsorption. Critical care physicians must be aware of potentially life-threatening complications due to phosphate abnormalities and identify the underlying etiology to make appropriate decisions. This chapter presents the diagnostic and therapeutic approach of hyperphosphatemia and hypophosphatemia in critically ill patients with cancer.
KeywordsHyperphosphatemia Hypophosphatemia Phosphate absorption Phosphate excretion Phosphate homeostasis Oncologic emergency Renal insufficiency Tumor lysis syndrome
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