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Abstract: FR-PO570

Skimmed Milk as an Alternative Treatment for Hypophosphatemia

Session Information

Category: Fluid‚ Electrolyte‚ and Acid-Base Disorders

  • 1002 Fluid‚ Electrolyte‚ and Acid-Base Disorders: Clinical


  • Padua, Kiara Marie H., Makati Medical Center, Makati City, Philippines
  • Zapanta, Ivan Kenneth Salazar, Makati Medical Center, Makati City, Philippines
  • Pascual, Christine De vera, Makati Medical Center, Makati City, Philippines
  • Esculto, Maricar, Makati Medical Center, Makati City, Philippines

Mild and Moderate Hypophosphatemia (1-2.5 mg/dL) are generally treated with oral supplements. However, oral phosphate is not accessible in the Philippines. Skimmed milk which is known to have high phosphorus content is readily available but no studies yet were done to evaluate its efficacy in correcting phosphorus.


A non-inferiority, open-label, randomized controlled pilot trial was done to assess the efficacy of skimmed milk (150ml divided into three doses, 0.03 mmol phosphorus: mL) compared to phosphate solution (60mL in three divided doses, 1mmol phosphorus: mL) in correcting mild and moderate hypophosphatemia. Mean percent change was used for the treatment difference, with the non-inferiority limit at 15%. Adverse events were noted and intention to treat was done.


Skimmed milk was able to increase phosphorus but was not different from phosphate solution (p = 0.86). There were seven participants who showed no increase in phosphorus post treatment, five of which were admitted in critical units (p = 0.68). The mean percent change was (50.32% vs 30.93%, p = 0.12) hence the mean percent change difference was -19.39% and is not statistically significant, however was outside the non-inferiority margin thus skimmed milk failed to show non-inferiority. There was abdominal pain and vomiting with phosphate solution.


Although, skimmed milk failed to show non-inferiority to phosphate solution, this pilot study showed that skimmed milk is an effective, safe, and readily available alternative for non-critically ill hypophosphatemic patients in resource-limited areas.