REHYDRATION IN THE TREATMENT OF SEVERE HYPERCALCEMIA

  • 1 January 1981
    • journal article
    • research article
    • Vol. 50  (200) , 473-481
Abstract
Sixteen episodes of severe hypercalcemia (> 3.25 mmol/l) were treated by rehydration alone. Na repletion was invariably achieved within 48 h (mean deficit 9.24 mmol/kg) although the fall in serum Ca was more protracted. A substantial fall in serum Ca (mean decrease 0.6 mmol/l) was achieved in 13 patients; poor responses in 3 patients were associated with a rapidly increasing Ca load. Presentation of the data in terms of Ca excretion per unit of glomerular filtrate and the setting of tubular reabsorption makes it possible to predict the likely effects of rehydration, and patients with non-metastatic hypercalcemia are easily identified. Rehydration is simple and often effective in the early management of this common metabolic problem, but it is important that therapeutic goals are realistic and the intrinsic limitations of rehydration recognized. This depends on a clear idea of the contribution that the kidney makes to the hypercalcemia of malignant disease.

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