The precautions used pre-emptively were close monitoring in intensive care unit (ICU) and high dependency unit (H DU), IV fluid hydration (3000ml/m 2/24hours), prophylactic allopurinol in a dose of 300mg/m2/day in three divided doses, restricted intake and output monitoring, preventing hyperkalaemia and hyperphosphataemia
. Urinary alkalinisation was avoided.
Possible risk factors affecting sleep quality in ESKD patients have been extensively reviewed, and the common factors reported include: male gender, advanced age, presence of RLS, high caffeine intake, alcohol, cigarette smoking, hyperphosphataemia
, anaemia, low plasma albumin concentration and inadequate dialysis (Al-Hahdali, 2012; Al-Jahdali, 2011; Chu et al., 2018; Gusbeth-Tatomir et al., 2007).
Goodman, "Importance of hyperphosphataemia
in the cardio-renal axis," Nephrology Dialysis Transplantation , vol.
The indication for surgical intervention are PTH level > 800pg/mL, hypercalcemia, hyperphosphataemia
, hypercalciuria, and severe symptom of hyperparathyroidism including unbearable bone pain, osteoporosis/osteopenia, and severe pruritus [11, 12].
Against this diagnosis, our patient presented with marked hyperphosphataemia
(4.95mmol/L) and hypermagnesaemia (1.25mmol/L) which is inconsistent with the electrolyte derangement that are the hallmarks of refeeding syndrome [12,13].
Effectiveness of a nurse-led educational programme on chronic kidney failure patients with hyperphosphataemia
: Randomised controlled trial.
, hypocalcaemia, hypercalcaemia, elevated calcium-phosphate product (CaXP) and elevated ALP.
Management of hyperphosphataemia
: Practices and perspectives amongst the renal care community.
Sevelamer for hyperphosphataemia
in kidney failure: Controversy and perspective.
Hypocalcaemia is frequently associated with hyperphosphataemia
in CKD with its mechanism associated with primary hyposecretion of parathormone which results in a progressive decrease in blood calcium levels up to a steady state characterised by an equality between urinary calcium excretion and osseous calcium secretion [13,14].
and phosphate binders in chronic kidney disease.