HYPERCALCEMIA IN ASSOCIATION WITH ACUTE-RENAL-FAILURE AND RHABDOMYOLYSIS - CASE-REPORT AND LITERATURE-REVIEW

The syndrome of hypercalcemia during the course of acute renal failure (usually associated with rhabdomyolysis) occurs most commonly in youn g men with very severe renal failure. Although fewer than 90 such pati ents have been reported, the prevalence of hypercalcemia in patients w ith rhabdomyolysis-associated renal failure averages 30%. Hypercalcemi a occurs most commonly in the diuretic phase and resolves spontaneousl y. The mean duration of hypercalcemia is 14 days. The pathogenesis of this syndrome has not been clearly defined. In the rare instances wher e it has been measured, intact PTH is suppressed. In contrast, both el evated and suppressed values of plasma 1,25-dihydroxyvitamin D have be en reported. The release of calcium from ectopic calcification in dama ged muscle tissue provides a potential explanation for this syndrome. Therapy for the hypercalcemia should generally be conservative given i ts self-limited nature.