In 21 patients with acute hypophosphatemia (AHPP), we measured red cell intracellular Na concentration (Nai) and either total (T), ouabain-sensitive (OS) or ouabain-resistant (OR) efflux rate constant of Na (0K Na) in a 'physiological' Na medium. High Nai, normal 0K Na T, reduced 0K Na OS and normal 0K Na OR were found. Total OS and OR unidirectional Na effluxes were increased, normal and increased, respectively. The findings suggest that high Nai in AHPP is due to an impairment of active (OS) red cell Na transport; the increase of total Na efflux is only supported by the OR Na efflux, which, under physiological conditions, is mediated mostly by the 1 Na:1 Na exchange diffusion.

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