Hemodialysis for near-fatal sodium phosphate toxicity in a child receiving sodium phosphate enemas.

OBJECTIVE

This study aimed to demonstrate the importance of considering hemodialysis as a treatment option in the management of sodium phosphate toxicity.

METHODS

This is a case report of a 4-year-old who presented to the emergency department with shock, decreased mental status, seizures, and tetany due to sodium phosphate toxicity from sodium phosphate enemas.

RESULTS

Traditional management of hyperphosphatemia with aggressive hydration and diuretics was insufficient to reverse the hemodynamic and neurological abnormalities in this child. This is the first report of the use of hemodialysis in a child without preexisting renal failure for the successful management of near-fatal sodium phosphate toxicity.

CONCLUSIONS

Hemodialysis can safely be used as an adjunctive therapy in sodium phosphate toxicity to rapidly reduce serum phosphate levels and increase serum calcium levels in children not responding to conventional management.