skip to main content

Phosphate enema in CKD — GPhC CRA MCQ

Instant feedback + full explanation. One question, done properly.

HardRenal and Hepatic ImpairmentPhosphate enema in CKDGPhC CRA

A dehydrated patient with eGFR 22 mL/min/1.73 m² develops tetany and confusion after receiving a sodium-phosphate enema. Which electrolyte pattern is most consistent with the recognised toxicity?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: E — Raised phosphate with reduced calcium

Rectal phosphate can be absorbed systemically. In renal impairment and dehydration, phosphate clearance is reduced and severe hyperphosphataemia may drive hypocalcaemia, producing neuromuscular and neurological manifestations. The product is contraindicated in clinically significant renal impairment and dehydration; this is not a purely local rectal treatment.

Reference: Fletcher’s Phosphate Enema (Short Tube) SmPC: https://www.medicines.org.uk/emc/product/100649/smpc