Hypercalcemia in patients with advanced chronic renal failure not yet requiring dialysis.
Six patients with progressive chronic renal failure not yet requiring dialysis and not consuming supplemental calcium or vitamin D developed hypercalcemia. Three had proven and 1 suspected tertiary hyperparathyroidism, 1 parathyroid carcinoma and 1 aplastic bone. None of the 3 patients who underwent bone biopsy had heavy bone aluminum staining. The patients with proven parathyroid-mediated hypercalcemia had marked elevation of C-terminal parathyroid hormone and alkaline phosphatase values and, when performed, radiographs consistent with osteitis fibrosa. When these findings are absent or the diagnosis is otherwise uncertain, a bone biopsy may provide a definitive diagnosis and guide management.
Department of Medicine, School of Medicine, University of Pittsburgh, Pa.
A
A
Greenberg
B M
BM
Piraino
F J
FJ
Bruns
D000328:Adult; D001842:Bone and Bones / Q000473:pathology; D005260:Female; D006801:Humans; D006934:Hypercalcemia / Q000097:blood / Q000209:etiology* / Q000473:pathology; D006962:Hyperparathyroidism, Secondary / Q000150:complications / Q000473:pathology / Q000601:surgery; D007676:Kidney Failure, Chronic / Q000150:complications*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies