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Juri Katchanov 7:07 pm on September 16, 2019 Permalink | Reply

hypercalcemia

Milk alkali (= Calcium alkali) the third most common cause of hospital admission for hypercalcemia in the US

-from excess consumption of calcium supplements (e.g., calcium carbonate).

Milk alkali trias:

(1) hypercalcemia

(2) metabolic alkalosis (from nephrogenic DI), and

(3) renal insufficiency (prerenal & intrarenal: calcium-induced renal tubular damage and vasoconstriction of the renal afferent arteriole)

Treatment: intravenous fluid resuscitation and cessation of calcium supplementation

DO NOT USE Dronates in Calcium-Alkali syndrome (risk of hypocalcemia). The patient with Calcium-Alkali syndrome is cessation of Ca supplementation- the patient will respond quickly.
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Juri Katchanov 6:12 pm on September 16, 2019 Permalink | Reply

hypocalcemia

Calcium gluconate does NOT require hepatic activation to exert its effect:

Mythbuster: Calcium Gluconate Raises Serum Calcium as Quickly as Calcium Chloride
Juri Katchanov 10:00 am on February 13, 2012 Permalink | Reply

PEARLS Ca

Ca and AKI

AKI is usually hypOcalcemic! HypERcalcemia in AKI is indicative of a co-morbidity: (1) cancer (2) multiple myeloma (3) hyperpara (4) sarcoid (5) vit D intoxication (6) milk-alkali syndrome. Joel Topf

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