title: Severe hypercalcemia in nonobstructive pyelonephritis with acute renal failure: hit or miss?
abstract: Severe hypercalcemia in the course of renal failure is quite unusual. If unrecognized, irreversible inexorable attrition of renal function takes place, carrying a substantial morbidity and mortality. In particular, acute nonobstructive pyelonephritis is barely considered in the primary differential diagnosis of renal failure. Without urinary obstruction, kidney hypoperfusion, or exposure to nephrotoxic agents, a significant decline in glomerular filtration rate generally does not occur. We report a case with severe hypercalcemia after acute renal failure caused by fulminating bacterial pyelonephritis. To obviate unnecessary intervention, preserve organ function, and achieve better outcomes, clinicians should not miss this entity.
authors.affiliation: Division of Nephrology, Department of Medicine, Taoyuan General Hospital, Taoyuan, Taiwan.
authors.forename: Yu-Tzu
authors.initials: YT
authors.lastname: Tsao
authors.forename: Shih-Wei
authors.initials: SW
authors.lastname: Lee
authors.forename: Jin-Chyr
authors.initials: JC
authors.lastname: Hsu
authors.forename: Feng-Ming
authors.initials: FM
authors.lastname: Ho
authors.forename: Wei-Jie
authors.initials: WJ
authors.lastname: Wang
mesh_terms: D058186:Acute Kidney Injury / Q000150:complications*; D004636:Emergency Service, Hospital; D004927:Escherichia coli Infections / Q000150:complications; D005260:Female; D006801:Humans; D006934:Hypercalcemia / Q000175:diagnosis / Q000209:etiology*; D008875:Middle Aged; D011704:Pyelonephritis / Q000150:complications*