Document Detail

Hypocalcemia and hypercalcemia in patients with rhabdomyolysis with and without acute renal failure.
MedLine Citation:
PMID:  3011837     Owner:  NLM     Status:  MEDLINE    
Patients with rhabdomyolysis (RBD) and acute renal failure (ARF) are hypocalcemic during the oliguric phase of ARF and over 30% develop hypercalcemia during the diuretic phase. The present study examined the factors underlying these derangements in calcium metabolism in 15 patients: 7 with RBD and ARF, 4 with RBD only, and 4 with ARF only. All patients had hypocalcemia on admission and the hypocalcemia was more pronounced in those with RBD and ARF. All patients with RBD independent of the presence or absence of ARF had calcium deposition in soft tissues as documented by technetium-99 scan. In 4 patients with RBD and ARF, hypercalcemia developed during the diuretic phase at a time when Serum PTH levels were undetectable. Only patients with RBD and ARF had a significant increase in serum levels of 25-hydroxyvitamin D and 1,25-dihydroxyvitamin D [1,25(OH)2D] during the diuretic phase and both the increments in and the levels of 1,25(OH)2D were significantly greater in those who were hypercalcemic. The data indicate that 1) hypocalcemia occurs in RBD independent of ARF and is most likely related to calcium deposition in injured tissues, and 2) elevation in serum levels of 1,25(OH)2D plays an important role in the genesis of hypercalcemia during the diuretic phase of patients with RBD and ARF. Our observations suggest that extrarenal production of 1,25(OH)2D may occur in these patients, and/or that the renal production of 1,25(OH)2D may not be so tightly controlled as it is in normal subjects.
M Akmal; J E Bishop; N Telfer; A W Norman; S G Massry
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Publication Detail:
Type:  Journal Article; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  The Journal of clinical endocrinology and metabolism     Volume:  63     ISSN:  0021-972X     ISO Abbreviation:  J. Clin. Endocrinol. Metab.     Publication Date:  1986 Jul 
Date Detail:
Created Date:  1986-07-18     Completed Date:  1986-07-18     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  0375362     Medline TA:  J Clin Endocrinol Metab     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  137-42     Citation Subset:  AIM; IM    
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MeSH Terms
Calcinosis / etiology,  radionuclide imaging
Calcitriol / blood
Diphosphates / diagnostic use
Hypercalcemia / etiology*
Hypocalcemia / etiology*
Kidney Failure, Acute / blood*,  complications,  physiopathology
Middle Aged
Parathyroid Hormone / blood
Rhabdomyolysis / blood*,  complications,  physiopathology
Technetium / diagnostic use
Technetium Tc 99m Pyrophosphate
Time Factors
Grant Support
Reg. No./Substance:
0/Diphosphates; 0/Parathyroid Hormone; 0/Technetium Tc 99m Pyrophosphate; 32222-06-3/Calcitriol; 7440-26-8/Technetium

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