[Hypercalcaemic crisis and acute renal failure due to primary hyperparathyroidism].
Hypercalcaemic crisis is a rare endocrine emergency. Often, an acute renal failure develops due to hypercalcaemia-induced polyuria. The molecular causes comprise stimulation of the calcium-sensing receptor in the ascending Henle loop and a reduced aquaporin expression in the collecting ducts. We report on a 54-year-old woman who was admitted for hypercalcaemic crisis and acute renal failure. Immediate rehydratation, bisphosphonate administration, and slow-extended daily dialysis (SLEDD) were initiated leading to a marked reduction of serum calcium. Endocrine work-up revealed primary hyperparathyroidism due to a parathyroid adenoma, which was treated by emergency surgery. Haemodialysis was continued in the first post-operative weeks for prolonged acute renal failure.
Georges
C G
CG
Abteilung für Endokrinologie, Diabetes, Angiologie, Nephrologie und Klinische Chemie, Medizinische Klinik, Universitätsklinikum Tübingen. georg.georges@med.uni-tuebingen.de
Guthoff
M
M
Wehrmann
M
M
Teichmann
R
R
Gröne
E
E
Artunc
F
F
Risler
T
T
Friedrich
B
B
Müssig
K
K
D058186:Acute Kidney Injury / Q000209:etiology* / Q000628:therapy; D000236:Adenoma / Q000150:complications / Q000175:diagnosis / Q000601:surgery; D004164:Diphosphonates / Q000627:therapeutic use; D004630:Emergencies; D005260:Female; D005440:Fluid Therapy; D006801:Humans; D006934:Hypercalcemia / Q000209:etiology* / Q000628:therapy; D049950:Hyperparathyroidism, Primary / Q000150:complications* / Q000175:diagnosis / Q000209:etiology; D000077557:Ibandronic Acid; D008875:Middle Aged; D010282:Parathyroid Neoplasms / Q000150:complications / Q000175:diagnosis / Q000601:surgery; D006435:Renal Dialysis / Q000379:methods
D004164:Diphosphonates; D000077557:Ibandronic Acid