Phosphorus-enriched Dialysate Workflow

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Paul MacDowell
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Phosphorus-enriched Dialysate Workflow

I'm evaluating workflow for enriching hemodialysis solution with sodium phosphate additive. This is somewhat of an unconventional workflow from pharmacy perspective, so trying to ensure safety of this process. There are reports in literature of hemodialysis solution being enriched with fleets enema or sodium phos 3mmol/mL injection added to final solution. Brief overview of practice is found here: https://doi.org/10.5301/ijao.5000453

Questions:
- Does your pharmacy provide phosphate product (fleet enema or injectable Na Phos) to dialysis RN to mix into hemodialysis solution? If yes, are you able to share any example of order or order set?

- If you engage in this practice what formulation is used (ie fleet enema, injectable, other)?

- Any other advice/ comments in implementing this type workflow?