SYMPTOMATIC HYPERCALCEMIA IN A DIABETIC PATIENT UNDERGOING CONTINUOUS AMBULATORY PERITONEAL-DIALYSIS - VALUE OF BONE-BIOPSY IN THE DIAGNOSIS AND MANAGEMENT

• Type: Article in International Scientific Journal
• Date: 1995

Authors

João Frazão (Author) Other; COBURN, JW (Author) Other

Journal

Title: American Journal of Kidney Diseases

Vol. 26

Pages: 831-835

ISSN: 0272-6386

Publisher: Elsevier

Indexing

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Other information

Authenticus ID: P-008-PTT

DOI: 10.1016/0272-6386(95)90452-2

Abstract (EN): An elderly man with diabetes mellitus and end-stage renal disease managed with continuous ambulatory peritoneal dialysis (CAPD) was hospitalized with peripheral vascular insufficiency; he developed hypercalcemia and became mentally obtunded, Lowering dialysate Ca from 3.5 mEq/L to 2.5 mEq/L, stopping calcium acetate, and ultimately hemodialysis with calcium-free dialysate did not lead to reversal of the hypercalcemia or improvement of his symptoms, The intact parathyroid hormone PTH level was 187 pg/mL, a value rarely associated with significant osteitis fibrosa, A search for other causes of hypercalcemia was unrevealing, and a iliac crest bone biopsy was done, The latter showed osteitis fibrosa, and the patient underwent parathyroidectomy, The hypercalcemia reversed quickly, and his mental symptoms slowly improved, The discussion reviews the probable causes of hypercalcemia in diabetic patient undergoing CAPD with 3.5 mEq/L dialysate calcium and using calcium-containing phosphate binders, with hyperparathyroidism certainly not the usual cause, The reason for the occurrence of significant hyperparathyroidism in the face of only modest elevation of PTH is considered, The value of bone biopsy in resolution of this problem is apparent. (C) 1995 by the National Kidney Foundation, Inc.

Language: English

Type (Professor's evaluation): Scientific

No. of pages: 5