The nurse is caring for a patient with
• In clients with significant kidney disease, the kidneys do not excrete enough phosphate. Dialysis helps clear the blood of waste products, urea, creatinine, and uric
• Hyperphosphatemia is treated by reducing dietary intake of phosphate and by administration of drugs called
• As phosphate levels rise, serum calcium lowers as the calcium is consumed in the formation of calcium phosphate. Phosphate also inhibits vitamin D hydroxylation by the kidneys. Vitamin D acts to increase dietary calcium absorption, so hyperphosphatemia contributes to hypocalcemia in this way, as well.
• Hyperphosphatemia alone does not usually cause symptoms, but in clients with kidney disease, high phosphate accompanies low calcium. Hypocalcemia can cause muscle cramps and spasms (tetany), tingling (often in the face or fingers), seizures, or abnormal heart rhythms.
• Hypernatremia is associated with kidney disease, but sodium levels are not affected much by these foods. High sodium and the excess fluid that goes along with it is managed with dialysis.