Milk-alkali syndrome presenting as acute renal insufficiency during pregnancy.
BACKGROUND
Gastroesophageal reflux is common during pregnancy. Hypercalcemia from overuse of antacids can lead to complications, including the milk-alkali syndrome.


METHODS
A multiparous patient, at 35 weeks of gestation, was admitted to evaluate an unexplained increase in her serum creatinine (0.6 mg/dL to 1.4 mg/dL). She was normotensive and asymptomatic. Her serum calcium was 16.2 mg/dL. She reported significant gastric reflux symptoms and was taking a calcium-based antacid at high doses. She was treated with aggressive hydration. Her calcium and renal function normalized with no further complications.


CONCLUSIONS
Overuse of calcium-containing medications can cause milk-alkali syndrome. Vigorous hydration is generally adequate treatment, and education regarding calcium intake is important to prevent occurrence.
Ennen
Christopher S
CS
Department of Obstetrics and Gynecology, Naval Medical Center, Portsmouth, VA 23708, USA. csennen@mar.med.navy.mil
Magann
Everett F
EF
D000863:Antacids / Q000009:adverse effects; D002118:Calcium / Q000009:adverse effects / Q000097:blood; D003404:Creatinine / Q000097:blood; D003937:Diagnosis, Differential; D005260:Female; D005764:Gastroesophageal Reflux / Q000188:drug therapy; D005865:Gestational Age; D006801:Humans; D006934:Hypercalcemia / Q000139:chemically induced / Q000150:complications / Q000175:diagnosis*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis*; D051437:Renal Insufficiency
D000863:Antacids; D003404:Creatinine; D002118:Calcium