A patient under CAPD treatment who developed severe hypophosphatemia during peritonitis.

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We report a case showing severe hypophosphatemia in the course of peritonitis under continuous ambulatory peritoneal dialysis (CAPD) treatment.A 43-year-old man who had undergone CAPD since March of 1987, was admitted to our hospital because of the peritonitis in June 7 of 1988. Intraperitoneal and systemic administration of antibiotics was done in addition to frequent exchanges of dialysates. On admission, his serum phosphate level was within normal range, but fell rapidly to less than 1.0mg/dl. Finally, he developed lethargy and involuntary movement of the extremities. Intraperitoneal replacement of phosphate was instituted, and his symptoms improved. Laboratory examination showed elevation of CPK and myoglogin, considered to be due to rhabdomyolysis associated with hypophosphatemia. His serum phoshate level returned to normal after improvement of the peritonitis.In conclusion, careful monitoring of the phosphate level is needed during peritonitis under CAPD treatment.
社団法人日本透析医学会の論文