Learning Objective At the conclusion of my presentation, participants will be able to describe the effect of parenteral phosphate supplementation dose on serum phosphorus levels in the pediatric patient population. Objective This study is designed to evaluate the effect of parenteral phosphate dosing on serum phosphate concentration by evaluating current dosing practices Background/Objective There is a current paucity of data regarding the dosing of parenteral phosphate in the pediatric patient population. Methods This is a single center retrospective chart review evaluating infants, children and adolescents admitted in a children’s hospital within an adult institution who received parenteral intermittent sodium or potassium phosphate from August 2012 - August 2025. The primary outcome is to evaluate the effect of parenteral phosphate dose on the change in serum phosphorus concentration in the pediatric patient population. Secondary outcomes include the need for resupplementation within 24 hours of a repeat phosphorus level, the number of doses and amount of time required to achieve a serum phosphorus level > 2 mg/dL and the incidence of hyperphosphatemia as a result of current parenteral phosphate dosing strategies. Results Of the 152 patients screened, 109 patients were included in the study across 164 administrations of parenteral phosphate. The mean change in serum phosphorus (SD) for the entire study population was 0.53 mg/dL (± 0.98). The mean change in serum phosphorus in the low, medium, high, and very high dose groups were 0.65 mg/dL (± 0.71), 0.53 mg/dL (± 0.78), 1.05 mg/dL (± 1.07), and 1.59 mg/dL (± 1.66) respectively. Persistent hypophosphatemia occurred in 134 (81.8%) administrations, while hyperphosphatemia occurred in 4 (2.4%) of administrations. Conclusion Statistical analysis for this study is still ongoing, though descriptive statistics for the primary outcome appear to show a linear relationship between parenteral phosphorus dose and change in serum phosphorus concentration. Given the high rates of persistent hypophosphatemia seen in this study across all dosing ranges, it may be appropriate to consider higher phosphate dosing in the pediatric population, however, further studies may be needed to elucidate the ideal dosing regimen based on serum phosphorus level. Self-Assessment Question Which of the following medication classes are a major risk factor for the development of hypophosphatemia? Select all that apply.
