title: Iatrogenic nephrocalcinosis with acute renal failure: an underestimated complication after parathyroidectomy?
abstract: Hypocalcaemia often occurs in patients after parathyroidectomy (PTX) due to hypoparathyroidism and/or hungry bone syndrome. To avoid hypocalcaemia, patients are substituted with large doses of calcium and vitamin D. Here, we present four patients, who developed acute renal failure with hypercalcaemia and/or histologically confirmed nephrocalcinosis after PTX due to oversubstitution with vitamin D analogues and calcium. As a consequence, serum and urinary calcium should be closely monitored after PTX, and calcium and vitamin D substitution should be continuously adapted to avoid not only hypocalcaemia but also nephrocalcinosis and hypercalcaemic renal failure.
authors.affiliation: Division of Nephrology , University Hospital Zürich , Switzerland.
authors.forename: Barbara C
authors.initials: BC
authors.lastname: Fritschi
authors.affiliation: Clinic for Nephrology , Stadtspital Waid Zürich , Switzerland.
authors.forename: Johannes
authors.initials: J
authors.lastname: Trachsler
authors.affiliation: Institute of Surgical Pathology , University Hospital Zürich , Switzerland.
authors.forename: Zsuzsanna
authors.initials: Z
authors.lastname: Varga
authors.affiliation: Clinic for Nephrology , Cantonal Hospital St. Gallen , Switzerland.
authors.forename: Isabelle
authors.initials: I
authors.lastname: Binet
authors.affiliation: Division of Nephrology , University Hospital Zürich , Switzerland.
authors.forename: Thomas
authors.initials: T
authors.lastname: Fehr
keywords: acute renal failure; nephrocalcinosis; parathyroidectomy; vitamin D substitution