Severe hypocalcaemia and hyperphosphataemia caused by oral sodium phosphate fleet solution in a haemodialysis patient after parathyroidectomy

We report a case with severe electrolyte disturbance after the use of oral sodium phosphate solution (OSPS). A 69-year-old patient on haemodialysis received 45 mL of OSPS for bowel preparation. He had symptomatic hypocalcaemia with a serum calcium level of 0.95 mmol/L and serum phosphate level of 4.73 mmol/L. He was treated with haemodialysis and intravenous calcium supplementation. This patient had total parathyroidectomy recently leading to the absence of parathyroid hormone response. OSPS has been reported to cause life-threatening electrolyte disturbance especially in patients with renal failure. We suggest the use of safer alternatives for bowel preparations in renal failure patients.