Metabolic acidosis-induced hypercalcemia in an azotemic patient with primary hyperparathyroidism
| Autor: | Mandana Rastegar, Barton S. Levine, Arnold J. Felsenfeld |
|---|---|
| Rok vydání: | 2014 |
| Předmět: |
metabolic acidosis
renal failure medicine.medical_specialty Cinacalcet chemistry.chemical_element Calcium bone Clinical Reports chemistry.chemical_compound Internal medicine medicine primary hyperparathyroidism Acidosis Calcium metabolism Transplantation Sodium bicarbonate business.industry hypercalcemia Metabolic acidosis medicine.disease Endocrinology chemistry Nephrology Clinical Cases medicine.symptom business Primary hyperparathyroidism Kidney disease medicine.drug |
| Zdroj: | Clinical Kidney Journal |
| ISSN: | 2048-8513 2048-8505 |
| DOI: | 10.1093/ckj/sfu041 |
| Popis: | A 58-year-old man with Stage 3b chronic kidney disease and primary hyperparathyroidism treated with cinacalcet was admitted for acute cholecystitis. A cholecystostomy tube was placed, estimated glomerular filtration rate decreased, metabolic acidosis developed and ionized calcium increased from 1.33 to 1.76 mM despite cinacalcet administration. A sodium bicarbonate infusion corrected the metabolic acidosis restoring ionized calcium to normal despite no improvement in renal function. The correlation between the increase in serum bicarbonate and decrease in ionized calcium was r = −0.93, P < 0.001. In summary, severe hypercalcemia was attributable to metabolic acidosis increasing calcium efflux from bone while renal failure decreased the capacity to excrete calcium. |
| Databáze: | OpenAIRE |
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