An audit on the management of hypophosphataemia on the wards in a district general hospital in the UK

Hypophosphataemia or low serum phosphate, if severe can be life-threatening. However, mild hypophosphataemia is quite common and usually asymptomatic. Symptomatic hypophosphataemia (normal: 0.8-1.5 mmol/L) is usually observed when serum phosphate falls below 0.3 mmol/L. Complications may include myopathy, rhabdomyolysis, respiratory failure. cardiac arrhythmias, cardiomyopathy, acute heart failure. delirium, seizures, metabolic encephalopathy and coma. Severe hypophosphataemia can also be related to anaemia, infection, osteomalacia, insulin resistance, ileus and renal tubular failure. Therefore, an audit was carried out for 1 month at the beginning of 2024 to find out whether hypophosphataemia was properly managed on the wards in accordance with the prevailing Guidelines. The findings suggested that although blood tests for Parathyroid hormone (PTH), Cortisol and 24 hours urinary phosphate were done in a small number of patients, in most cases, the management of hypophosphataemia was adequate.