Hyperphosphatemia due to fosphenytoin in a pediatric ESRD patient.
Hyperphosphatemia due to fosphenytoin in a pediatric ESRD patient.
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儿童终末期肾病 (ESRD) 患者因磷苯妥英导致高磷血症。
DOI：
10.1007/s00467-005-1947-0
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发表时间：
2005
期刊：
影响因子：
--
通讯作者：
Kher,KanwalK
中科院分区：
文献类型：
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作者：
McBryde,KevinD;Wilcox,Jennifer;Kher,KanwalK
磷苯妥英钠适用于治疗神经外科手术期间发生的全身性惊厥和癫痫发作。磷苯妥英的代谢产物包括苯妥英、磷酸盐和甲醛。该药物专论建议对需要限制磷酸盐摄入的患者慎用磷苯妥英。此外，磷苯妥英改变了终末期肾病患者的药代动力学。我们报告了一例17岁的非洲裔美国男性终末期肾病患者，在静脉注射1000 mg磷苯妥英治疗特发性复杂部分性癫痫发作后发生急性高磷血症至3.9 mmol/L（12.1 mg/dL）。据我们所知，这是首次报告急性高磷血症由于磷苯妥英钠管理。由于高磷血症的风险，我们建议在终末期肾病人群中谨慎使用磷苯妥英。
Fosphenytoin is indicated for the treatment of generalized convulsions and seizures occurring during neurosurgery. Metabolites of fosphenytoin include phenytoin, phosphate, and formaldehyde. The drug monograph recommends caution in administering fosphenytoin to patients in whom phosphate restriction is necessary. Additionally, fosphenytoin has altered pharmacokinetics in end-stage renal disease patients. We report a 17-year old African-American male with end-stage renal disease who developed acute hyperphosphatemia to 3.9 mmol/L (12.1 mg/dL) following the intravenous administration of 1000 mg of fosphenytoin for an idiopathic complex partial seizure. To our knowledge, this is the first report of acute hyperphosphatemia due to fosphenytoin administration. Due to this risk of hyperphosphatemia, we recommend that fosphenytoin should be used with caution in the end-stage renal disease population.