Phoxilium vs Hemosol-B0 for continuous renal replacement therapy in acute kidney injury

J Crit Care. 2013 Oct;28(5):884.e7-14. doi: 10.1016/j.jcrc.2013.02.013. Epub 2013 May 14.


Purpose: This study aimed to compare the biochemical effects of Phoxilium (containing phosphate at 1.2 mmol/L; Gambro Lundia AB, Lund, Sweden) and Hemosol-B0 (Gambro Lundia AB) as dialysate and/or replacement fluid during continuous renal replacement therapy (CRRT).

Methods: We examined serum biochemistry in critically ill patients for 42 hours of Phoxilium administration for the prevention of hypophosphatemia during CRRT and compared them with corresponding results in random historical controls who received Hemosol-B0.

Results: We studied 15 patients in each arm (Phoxilium vs Hemosol-B0). Respective median ages were 57 (49-68) and 64 (57-67) years. Baseline patient illness severity scores, prescribed CRRT effluent rates, and cumulative phosphate intakes were comparable. After 36 to 42 hours of Phoxilium administration, serum phosphate levels increased from 0.95 (0.81-1.13) to 1.44 (1.23-1.78) mmol/L, in contrast to the decline from 1.71 (1.09-2.00) to 0.83 (0.55-1.59) mmol/L with Hemosol-B0 (P=.0001). Serum ionized calcium levels decreased from 1.27 (1.22-1.37) to 1.12 (1.06-1.21) mmol/L with Phoxilium, compared with an increase from 1.09 (0.90-1.19) to 1.20 (1.16-1.25) mmol/L with Hemosol-B0 (P<.0001). Serum bicarbonate, base excess levels, and effective strong ion difference decreased with Phoxilium and were lower than those with Hemosol-B0 at 36 to 42 hours (P<.05).

Conclusion: Phoxilium effectively prevented hypophosphatemia during CRRT but was associated with relative metabolic acidosis and hypocalcemia compared with Hemosol-B0 use.

Keywords: Acid-base balance; Acute kidney injury; Continuous renal replacement therapy; Critical illness; Electrolyte abnormalities; Hemosol-B0; Hyperphosphatemia; Hypocalcemia; Hypophosphatemia; Metabolic acidosis; Nutrition; Phosphate-containing solution; Phoxilium.

Publication types

  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acute Kidney Injury / therapy*
  • Aged
  • Blood Substitutes / therapeutic use*
  • Case-Control Studies
  • Critical Illness*
  • Dialysis Solutions / therapeutic use*
  • Female
  • Humans
  • Hypophosphatemia / prevention & control*
  • Male
  • Middle Aged
  • Phosphates / therapeutic use*
  • Renal Replacement Therapy / methods*
  • Retrospective Studies
  • Treatment Outcome


  • Blood Substitutes
  • Dialysis Solutions
  • Phosphates