Categories: Nephrology

Hypercalcemia and Renal failure: Mechanism

Calcium homeostasis is normally under very tight control! There are 3 main sites of control: the gastrointestinal tract, bone, and kidney.

Hypercalcemia can happen for a variety of reasons (Multiple myeloma, cancer, Sarcoidosis, hyperparathyroidism, Milk-alkali syndrome, vitamin D intoxication etc.)

Subsequently acute renal failure may develop in the context of this pathology for several reasons.

HOW??

  • Polyuria during the hypercalcemia may cause hypovolemia and pre-renal AKI.
  • Vaso-constrictive effects of calcium. An increased influx of calcium into the vascular smooth muscle cells leads to an augmented muscular tone. Therefore increased vascular resistance and reduced renal perfusion.
  • Hypercalcemic nephrolithiasis. Formation of Ca2+-Oxalate stones, potentially causing obstruction and renal insufficiency.

REFERENCES

  1. Moysés-Neto M et al. Acute renal failure and hypercalcemia. Ren Fail. 2006;28(2):153-9.
  2. Simonetti G. Calcium and blood pressure. Ther Umsch. 2007 May;64(5):249-52.
  3. Carroll MF, Schade DS. A practical approach to hypercalcemia. Am Fam Physician. 2003 May 1;67(9):1959-66.
  4. Parks J, Coe F, Favus M. Hyperparathyroidism in Nephrolithiasis. Arch Intern Med. 1980;140(11):1479-1481.
Get Medical Pearls directly to your inbox every week!
Weekly posts with high yield medical knowledge, directly to your mailbox!
Dr. C Humphreys

Internal Medicine

Recent Posts

Trapped Lung vs. Lung Entrapment

Though often used synonymously; Trapped Lung and Lung Entrapment technically describe separate entities along the…

2 months ago

Cause of Pericardial Effusion in Pulmonary Hypertension: Pathogenesis

It is not clearly understood why patients with pulmonary hypertension (PH) develop pericardial effusions. However,…

3 months ago

Difference between Mycophenolate Mofetil vs. Mycophenolate Sodium

The two drugs are not interchangeable nor dose equivalents. Mycophenolate mofetil (Cellcept) is a semi…

3 months ago

What is an “Anephric” Creatinine Rise?

Serum Creatinine can be a deceptive surrogate during an acute kidney injury. It may lag…

1 year ago

Macrophage activation syndrome vs. Hemophagocytic lymphohistiocytosis

Macrophage activation syndrome (MAS) is a life-threatening complication of rheumatic diseases (i.e SLE, Juvenile idiopathic…

1 year ago

When does a Tracheostomy mature?

After creation of a percutaneous tracheotomy site for prolonged ventilation, one of the immediate complications…

1 year ago

This website uses cookies.