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James P. Knochel, MD
Arch Intern Med. 1977;137(11):1639-1640. doi:10.1001/archinte.1977.03630230107034.
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In Reply.—  Dr Darsee took issue with a statement I made that hypercalcemia of any cause is a contraindication to the use of phosphate salts. This statement was not made without consternation.I am aware that phosphate salts are very effective as a treatment for lowering the serum calcium concentration. After this form of treatment was reawakened in 1966,1 its usefulness was confirmed,2 but its dosage and rate of administration was a bit excessive and the authors later recommended that it be reduced.3,4 Fatalities had occurred.5 Unquestionably, damage to the eye, kidney, lung, vessels, and other less vital soft tissues can occur if excess phosphate salts are administered.6 There is also a strong possibility that adverse effects are more likely if a hypercalcemic patient also has alkalosis or renal insufficiency.7At the present time, several alternative methods of treatment for hypercalcemia are available that


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