高磷酸鹽血症（hyperphosphatemia）的定義根據Harrison's Principles of Internal Medicine, 17th Edition為成人在空腹時的血清磷濃度大於5.5mg/dL（1.8 mmol/L），本案例患者為做大腸鏡檢前服用Fleet○RPhospho-soda○R（每5毫升含有monobasic sodium phosphate 2.4 g，diabasic sodium phosphate 0.9 g），疑似藥物使用不當造成高磷酸鹽血症（P：8.5mg/dL）與急性腎衰竭（acute renal failure），主因是檢查後照護上未即時監測電解質及給予適量水份。文獻中建議對於年紀大、腎功能不佳、高血壓和使用血管收縮素轉化酶抑制劑或血管張力素受器阻斷劑的患者，或許可以考慮改用polyethylene glycol-based的瀉劑來取代，對於高危險性患者是一較安全的選擇

Hyperphosphataemia was defined in adults as a fasting serum phosphate concentration >5.5 mg/dL (1.8 mmol/L) by Harrison's Principles of Internal Medicine, 17th Edition. This case received Fleet○R Phospho-soda○R (each 5 ml contains monobasic sodium phosphate 2.4 g，diabasic sodium phosphate 0.9 g) for colonoscope, then the patient was suspected hyperphosphatemia (P：8.5mg/dL) and acute renal failure due to improper use of medication. The main reasons were not frequently monitoring the electrolyte and giving enough amount of fluid. Potential etiologic factors include inadequate hydration, aged patient, a history of hypertension, and concurrent use of an angiotensin-converting enzyme inhibitor or angiotensin receptor blocker. The use of polyethylene glycol-based purgatives should be considered for older patients and possibly for those with comorbid medical conditions.