Iatrogenic hypercalcemia in hemodialysis patients.
Article Details
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Muhammedi MA, Piraino B, Rault R, Johnston JR, Puschett JB
Iatrogenic hypercalcemia in hemodialysis patients.
Clin Nephrol. 1991 Nov;36(5):258-61.
- PubMed ID
- 1752077 [ View in PubMed]
- Abstract
Calcium carbonate is frequently used in large doses as a phosphorus binder in hemodialysis patients, which often results in hypercalcemia. In most studies in which calcium carbonate is prescribed to control serum phosphorus levels the patients are not given calcitriol. However, calcitriol may be necessary for suppression of parathyroid hormone. The risk of hypercalcemia when calcium supplements are used in conjunction with calcitriol has not previously been examined in detail. We reviewed the charts of 74 hemodialysis patients (119 patient dialysis years) to determine the relationship of serum calcium to calcitriol, calcium therapy, and PTH levels. Twenty-eight patients (38%) were hypercalcemic at some point. Calcitriol therapy significantly increased the risk of hypercalcemia, independently of calcium therapy (p = 0.032). However, patients on a low dose of calcitriol were more than twice as likely to be hypercalcemic than patients on higher doses. Mean PTH levels were lower in the patients on the lower doses of calcitriol, indicating less severe hyperparathyroid disease. We conclude that hypercalcemia is a common complication in hemodialysis patients on calcitriol and calcium carbonate. Whether lowering the dialysate calcium, as suggested by other investigators, will successfully decrease the risk of hypercalcemia without worsening hyperparathyroidism remains to be determined.
DrugBank Data that Cites this Article
- Pharmaco-proteomics
Drug Drug Groups Gene Gene ID Change Interaction Chromosome Calcitriol Approved Nutraceutical PTH 5741 decreased Calcitriol results in decreased expression of PTH protein 11p15.3 Calcitriol Approved Nutraceutical PTH 5741 decreased Calcitriol results in decreased expression of PTH protein 11p15.3 Calcitriol Approved Nutraceutical PTH 5741 decreased Calcitriol results in decreased expression of PTH protein 11p15.3 Calcitriol Approved Nutraceutical PTH 5741 decreased Calcitriol results in decreased expression of PTH protein 11p15.3 Calcitriol Approved Nutraceutical PTH 5741 decreased Calcitriol results in decreased expression of PTH protein 11p15.3 Calcitriol Approved Nutraceutical PTH 5741 decreased Calcitriol results in decreased expression of PTH protein 11p15.3 Calcitriol Approved Nutraceutical PTH 5741 decreased Calcitriol results in decreased expression of PTH protein 11p15.3 Calcitriol Approved Nutraceutical PTH 5741 decreased Calcitriol results in decreased expression of PTH protein 11p15.3 Calcitriol Approved Nutraceutical PTH 5741 decreased Calcitriol results in decreased expression of PTH protein 11p15.3 Calcitriol Approved Nutraceutical PTH 5741 decreased Calcitriol results in decreased expression of PTH protein 11p15.3 Calcitriol Approved Nutraceutical PTH 5741 decreased Calcitriol results in decreased expression of PTH protein 11p15.3 Calcitriol Approved Nutraceutical PTH 5741 decreased Calcitriol results in decreased expression of PTH protein 11p15.3 Calcitriol Approved Nutraceutical PTH 5741 decreased Calcitriol results in decreased expression of PTH protein 11p15.3 Calcitriol Approved Nutraceutical PTH 5741 decreased Calcitriol results in decreased expression of PTH protein 11p15.3 Calcitriol Approved Nutraceutical PTH 5741 decreased Calcitriol results in decreased expression of PTH protein 11p15.3 Calcium carbonate Approved Investigational PTH 5741 decreased Calcium Carbonate results in decreased expression of PTH protein 11p15.3 Calcium carbonate Approved Investigational PTH 5741 decreased Calcium Carbonate results in decreased expression of PTH protein 11p15.3 Calcium carbonate Approved Investigational PTH 5741 decreased Calcium Carbonate results in decreased expression of PTH protein 11p15.3 Calcium carbonate Approved Investigational PTH 5741 decreased Calcium Carbonate results in decreased expression of PTH protein 11p15.3