Severe Hypercalcemia in Oliguric Phase of Acute Renal Failure Associated with Rhabdomyolysis.
- Author:
Su Jin LIM
1
;
Seung Hee LEE
;
Chang Ki MOON
;
Jun Oh JUNG
;
Sang Joon PARK
;
Yun Kwon KIM
;
So Yon KIM
;
Young Jung KIM
;
Min Koo CHO
;
Gwon Jun LEE
Author Information
1. Department of Internal Medicine, National Police Hospital, Seoul, Korea. puspen@hanmail.net
- Publication Type:Case Report
- Keywords:
Hypercalcemia;
Oliguric phase;
Acute renal failure;
Rhabdomyolysis
- MeSH:
Acute Kidney Injury*;
Calcium;
Extracellular Fluid;
Humans;
Hypercalcemia*;
Hyperparathyroidism, Secondary;
Immobilization;
Lower Extremity;
Male;
Metabolism;
Plasma;
Renal Dialysis;
Rhabdomyolysis*;
Syncope;
Vitamin D
- From:Korean Journal of Nephrology
2003;22(6):731-735
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Hypercalcemia rarely develops in patients with acute renal failure associated with rhabdomyolysis. If hypercalcemia occurs, it happens mostly in diuretic phase and rarely in oliguric phase. Secondary hyperparathyroidism, abnormal metabolism of Vitamin D, immobilization of patient, and release of calcium from injured muscle are considered as possible pathogenetic mechanisms of hypercalcemia in acute renal failure associated with rhabdomyolysis. Among them, dissolution of calcium from injured muscle into extracellular fluid is accepted as the major mechanism of pathogenesis of hypercalcemia. A twenty year old male patient, combat policeman, developed syncope in the course of regular physical training. He was diagnosed of acute renal failure associated with rhabdomyolysis at the hospital he initially visited. After being subjected to three sessions of acute hemodialysis, he was transferred to our hospital. During the treatment, laboratory test was performed upon his continuous complaints of lower extremity weakness. It showed severe hypercalcemia with plasma calcium level of 17.6 mg/dL. He was in oliguric phase at the time of this severe hypercalcemia. Patient's lower extremity weakness was gradually improved by hemodialysis using low calcium dialysate. He was discharged after his renal function became normal. He has been followed on regular basis.
