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Continuous arteriovenous hemofiltration--a new treatment in hypercalcemic crisis
Blood Purification
|January 1, 1988
Summary
Continuous arteriovenous hemofiltration (CAVH) temporarily normalized serum calcium in a patient with hypercalcemic crisis. This novel approach offers a potential treatment for medically refractory cases of hypercalcemia.
Area of Science:
- Nephrology
- Endocrinology
- Oncology
Background:
- Hypercalcemic crisis, often linked to parathyroid carcinoma, presents a severe medical emergency.
- Anuria and resistance to conventional treatments complicate management, necessitating alternative therapeutic strategies.
Observation:
- A patient with recurrent parathyroid carcinoma experienced hypercalcemic crisis with anuria, unresponsive to standard medical interventions.
- Continuous arteriovenous hemofiltration (CAVH) was initiated to manage the severe hypercalcemia.
Findings:
- CAVH effectively removed up to 24 mmol of calcium per 24 hours, achieving temporary normalization of serum calcium levels.
- Despite CAVH treatment, serum calcium levels began to rise again, indicating the need for definitive surgical intervention.
- An acute parathyroidectomy was ultimately performed to address the underlying cause of the persistent hypercalcemia.
Implications:
- Continuous arteriovenous hemofiltration (CAVH) shows promise as a temporizing measure for managing hypercalcemic crisis unresponsive to medical therapy.
- This case highlights the potential role of CAVH in stabilizing patients with severe hypercalcemia while awaiting definitive treatment, such as surgery.
- Further research is warranted to establish the efficacy and optimal use of CAVH in the context of hypercalcemic emergencies.