Hypercalcemia associated with kidney disease: it is not always what you think-a case report

Hypercalcemia is a disorder resulting either from impaired calcium renal reabsorption, excessive bone resorption or intestinal absorption, or a combination of these conditions. It can lead to both acute kidney injury and chronic kidney disease, which may develop in case of prolonged or recurrent hypercalcemia. Therefore, the coexistence of hypercalcemia and kidney damage requires prompt recognition of predisposing factors.

Case 1 shows a 63-year-old white male with renal impairment and hypercalcemia who presented with weight loss, general malaise, and muscle pain. Renal biopsy revealed renal damage due to hypercalcemia. The symptoms did not clearly indicate the cause of hypercalcemia; however, the diagnosis was finally made on the basis of a biopsy of the enlarged salivary gland. Case 2 shows a 39-year-old white male with hypercalcemia and acute kidney injury after an episode of seizures with a loss of consciousness. The contrast-enhanced computed tomography revealed conglomerate of lymph nodes located in the left groin. Case 3 shows a 35-year-old white man with acute kidney injury and hypercalcemia with multisite pain and recurrent infections. Computed tomography and magnetic resonance imaging of the spine showed bone osteolytic lesions.

The article presents clinical challenges in the diagnosis and early implementation of appropriate therapy for hypercalcemia. Quick diagnosis enables proper treatment of the underlying disease, normalization of serum calcium levels, and improvement of kidney function.