Persisting Hypocalcemia After Surgical Parathyroidectomy: The Differential Effectiveness of Calcium Citrate Versus Calcium Carbonate With Acid Suppression
| Autor: | Tibor Fülöp, Vonda Echols, Abdeen R. Farah Musa, Sabahat Afshan, Anna Lerant |
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| Rok vydání: | 2016 |
| Předmět: |
Parathyroidectomy
Adult Male medicine.medical_specialty Calcitriol medicine.drug_class medicine.medical_treatment Proton-pump inhibitor chemistry.chemical_element Calcium Achlorhydria Gastroenterology End stage renal disease Peritoneal dialysis Calcium Carbonate 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Renal Dialysis Internal medicine Medicine Humans Drug Interactions 030212 general & internal medicine Hypocalcemia business.industry Proton Pump Inhibitors General Medicine medicine.disease Calcium carbonate Endocrinology chemistry Kidney Failure Chronic 030211 gastroenterology & hepatology business Calcium Citrate medicine.drug |
| Zdroj: | The American journal of the medical sciences. 353(1) |
| ISSN: | 1538-2990 |
| Popis: | The effectiveness of oral calcium (Ca) may be contingent on a patient׳s factors beyond compliance, such as proton-pump inhibitor use and the choice of calcium supplements. A 32-year-old Hispanic male with end-stage renal disease on peritoneal dialysis underwent successful surgical parathyroidectomy (intact parathyroid hormone level: 2,328pg/mL; postsurgical: 287-69pg/mL [normal: 8.5-72.5]). His postoperative course was complicated by severe and recurrent hypocalcemia as outpatient and he needed repeated admissions for intravenous Ca gluconate. Initially, severe hypocalcemia (corrected Ca: 4.8-5.6mg/dL; nadir ionized Ca: 0.57-0.69mmol/L) was attributed solely to medical noncompliance with oral Ca carbonate (3750mg, 3×/day between meals) and calcitriol (2-4mcg/day). Recognizing coexisting treatment with proton-pump inhibitor, oral Ca supplement was changed to calcium citrate (2,850mg, 3×/day) with prompt resolution of hypocalcemia (corrected Ca: 8.1-8.3mg/dL). This current case and the included literature review emphasize the disproportionate effectiveness of Ca citrate in subjects with achlorhydria. |
| Databáze: | OpenAIRE |
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