title: Temporary loss of limb function secondary to soft tissue calcification in a patient with rhabdomyolysis-induced acute renal failure.
abstract: A case of unusually severe soft tissue calcification with temporary loss of limb function in a patient with rhabdomyolysis-induced acute renal failure (ARF) is described. A large dose of intravenous (IV) calcium was administered early in the hospital course to treat hypocalcemia, and hemodialysis, when initiated, was with a 1.75-mmol/L calcium dialysate. This case illustrates the danger of administering calcium supplementation and raises questions about the use of normal to high dialysate calcium concentration in the early stages of rhabdomyolysis-induced oliguric ARF. Calcium supplementation should be reserved for patients with clear clinical signs of hypocalcemia and dialysate calcium should be adjusted to prevent excessive positive calcium balance.
authors.affiliation: Department of Medicine, Michael Reese Hospital, Chicago, IL.
authors.forename: E P
authors.initials: EP
authors.lastname: Thyssen
authors.forename: S H
authors.initials: SH
authors.lastname: Hou
authors.forename: J C
authors.initials: JC
authors.lastname: Alverdy
authors.forename: D M
authors.initials: DM
authors.lastname: Spiegel
mesh_terms: D058186:Acute Kidney Injury / Q000209:etiology* / Q000628:therapy; D000328:Adult; D002114:Calcinosis / Q000139:chemically induced*; D002118:Calcium / Q000008:administration & dosage / Q000009:adverse effects*; D003240:Connective Tissue Diseases / Q000139:chemically induced*; D015314:Dialysis Solutions; D005542:Forearm; D006801:Humans; D006996:Hypocalcemia / Q000188:drug therapy; D008297:Male; D012206:Rhabdomyolysis / Q000150:complications*
chemical_list: D015314:Dialysis Solutions; D002118:Calcium