title: Catastrophic hypercalcemia as a technical complication in home hemodialysis.
abstract: Life-threatening hypercalcemia in dialysis patients is very unusual. We present a case where life-threatening hypercalcemia in a home hemodialysis patient resulted from a technical mistake. A 46-year-old woman, on home nocturnal hemodialysis, presented to the emergency room with history of altered sensorium, vomiting and sweating, which started 1 h after initiation of dialysis the previous night. Serum calcium was 6.5 mmol/L. She improved with 10 h of low-calcium hemodialysis. Investigation revealed that the drain port of the reverse osmosis machine was connected to the dialysis machine and the product water was connected to the drain leading to acute hypercalcemia.
authors.affiliation: Division of Nephrology, Department of Medicine, University Health Network, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Praveen
authors.initials: P
authors.lastname: Murlidharan
authors.affiliation: Division of Nephrology, Department of Medicine, University Health Network, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Christopher T
authors.initials: CT
authors.lastname: Chan
authors.affiliation: Division of Nephrology, Department of Medicine, University Health Network, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Joanne M
authors.initials: JM
authors.lastname: Bargman
keywords: dialysate; hemodialysis; hypercalcemia; reverse osmosis