Outcomes of patients with post-hepatectomy hypophosphatemia: A narrative review

Table 3 Summary of phosphate replacement regimes for hypophosphatemia

Indications		Formulation	Route of administration	Composition	Recommended dosage	Special considerations
Mild hypophosphatemia (0.65-0.81 mmol/L)		Phospho-soda (C.B. Fleet Company, Virginia)	Oral	180mg Na2HPO4 · 7H2O + 480 mg NaH2PO4 · H2O/mL Phosphate: 4.150 mmol/mL Sodium: 4.822 mEq/mL Potassium: 0	1000mg/d	Chronic renal failure / reduced glomerular filtration rate: to use half of recommended initial dose Causes diarrhoea
		Phospha 250 Neutral (Rising Pharmaceuticals, Inc., United States)	Oral	Elemental phosphorus 250 mg (8 mmol), Sodium 298 mg (13 mEq), and Potassium 45 mg (1.1 mEq)
Moderate hypophosphatemia (0.32-0.65 mmol/L)	Not on ventilator	Phospho-soda (C.B. Fleet Company, Virginia)	(same as above)	(same as above)	If ≥1.5 mg/dL: 1 mmol/kg of elemental phosphorus (minimum of 40 mmol and a maximum of 80 mmol) in 3-4 doses over 24 h If < 1.5 mg/dL: 1.3 mmol/kg of elemental phosphorus (maximum of 100 mmol) in 3-4 doses over 24 h	(same as above)
	On ventilator	Sodium phosphate (Abbott Laboratories, North Chicago, Illinois)	Intravenous	142 mg Na2HPO4 + 276 mg NaH2PO4 · H2O/mL Phosphate: 3.0 mmol/mL Sodium: 4.0 mEq/mL	0.08 mg/kg over 2-6 h if recent and uncomplicated HP 0.16 mg/kg over 2-6 h if prolonged and has multiple causes Maximum of 20 mmol/h	Chronic renal failure / reduced glomerular filtration rate: to use half of recommended initial dose
		Potassium phosphate (Invenex Pharmaceuticals, Grand Island, New York)		236 mg K2HPO4 + 224 mg KH2PO4/mL Phosphate: 3.003 mmol/mL 4.360 mEq/mL		Chronic renal failure / reduced glomerular filtration rate: to use half of recommended initial dose To avoid if potassium > 4mmol/L
Severe hypophosphatemia (< 0.32 mmol/L) / Critically ill patients, or with severe complications of hypophosphatemia		Sodium phosphate or potassium phospahte	(same as above)	(same as above)	0.08-0.16 mg/kg over 2-6 h	(same as above)