Calcium disorders

With a renal slant, high and low calcium [Ca] 15 mins.

Rob Hunter, Consultant Nephrologist. Part of Renal/Urology in the Edinburgh MBChB.

Hypercalcaemia

Acute severe hypercalcaemia is a medical emergency because it can cause cardiac dysrhythmia and coma.

Hypercalcaemia may be due to excessive PTH secretion (in primary or tertiary hyperparathyroidism) or due to other causes such as malignancy, in which PTH levels are suppressed.

Hypercalcaemia causes the kidney to make a dilute urine. (This effect is mediated in the loop of Henle, mimicking a loop diuretic such as furosemide.) Therefore patients are usually volume deplete at presentation. Volume resuscitation with copious IV 0.9% NaCl is an important part of management.

Core materials

• Concise and excellent guideline from the European Society for Endocrinology (html or pdf)
• Case(s) …

Hypocalcaemia

to follow …

Further info

• Electrolyte disorders, a general approach (this site)