ArticleBlood purification2026
Phoxilium® as a Phosphate-Sparing Solution for Continuous Renal Replacement Therapy in Paracetamol-Induced Acute Liver Failure.
Article in Blood purification, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
introductionHypophosphataemia is common in acute liver failure (ALF) and may worsen during continuous renal replacement therapy (CRRT) with phosphate-free fluids. We aimed to evaluate the safety and efficacy of Phoxilium®, a phosphate-containing CRRT fluid.
methodsWe conducted a retrospective single-center cohort study of paracetamol-induced ALF patients treated with CRRT between January 2018 and May 2024 as our ICU transitioned from Accusol® to Phoxilium®. We obtained data on demographics, biochemistry, and outcomes. We compared biochemical variables every 6 h up to 48 h post-CRRT initiation and then every 12 h until 168 h. The primary outcome was the occurrence of severe hypophosphataemia (<0.32 mmol/L).
resultsIn 38 ALF patients (Phoxilium® = 14 and Accusol® = 24), Phoxilium® was associated with a reduction in the incidence of severe hypophosphataemia (0% vs. 38%; p = 0.014), a reduction in its median burden (proportion of phosphate readings <0.81 mmol/L: 13% [interquartile range: 2-33%] vs. 44% [29-51%]; p = 0.001), and significantly lower phosphate supplementation requirements (median, 45 mmol [20-70 mmol] vs. 100 mmol [60-210 mmol]; p = 0.008). Phoxilium® patients experienced a small but significant decrease in median arterial pH and standard base excess, which remained within normal limits, but lower than with Accusol® (p = 0.018 and p = 0.046, respectively). No significant differences were observed in clinical outcomes.
conclusionIn paracetamol-induced ALF patients, Phoxilium® was associated with reduced incidence of severe hypophosphataemia, hypophosphataemia burden, and need of phosphate supplementation. Larger studies are needed to further assess its impact on ALF patient outcomes.
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