Treatment of extreme hypercalcaemia: the role of haemodialysis

Anna B. Basok, Boris Rogachev, Yosef Shmuel Haviv, Marina Vorobiov

Research output: Contribution to journalArticlepeer-review

14 Scopus citations

Abstract

A patient with extremely high calcium level of 23.9 mg/dL (5.97 mmol/L) was admitted to our department unconscious with pathological ECG recording, demonstrating shortening of QT interval. The patient was treated by fluid resuscitation, bisphosphonates, salmon calcitonin and steroids. Haemodialysis with low calcium bath had been promptly provided with improvement of consciousness and calcium level. ECG changes disappeared. Subsequent investigations revealed hyperparathyroidism and a large parathyroid adenoma was then surgically removed. Extreme and rapid calcium elevation (parathyroid crisis) is rarely seen in primary hyperparathyroidism and usually is distinctive for malignancy. In the context of acute kidney injury and refractory hypercalcaemia with life-threatening complications (coma, ECG changes with impending danger of arrhythmia), haemodialysis may effectively decrease calcium levels. It should be pointed out that dialysis is an efficient method of treatment of refractory hypercalcaemia, parathyroid crisis, but it is rarely used due to its invasive nature.

Original languageEnglish
JournalBMJ Case Reports
Volume2018
DOIs
StatePublished - 4 Jun 2018
Externally publishedYes

Keywords

  • acute renal failure
  • arrhythmias
  • calcium and bone
  • dialysis
  • fluid electrolyte and acid-base disturbances

ASJC Scopus subject areas

  • General Medicine

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