Rapid Appearance of Hypercalcemia With Initiation of Hemodialysis

Abstract
Symptomatic hypercalcemia developed in a patient with chronic renal failure within three weeks of initiation of adequate hemodialysis. He had anorexia, nausea, vomiting, pruritus, dysesthias, parasthesias, confusion, disorientation, and hypertension; these symptoms were controlled only after subtotal parathyroidectomy. Adequate hemodialysis may, in rare instances, unmask manifestations of preexisting secondary hyperparathyroidism in a manner similar to that observed after renal transplantation. The symptoms were very intense, and it is possible that uremia may increase the sensitivity to symptoms of hypercalcemia.

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