The aim of the study was to assess the incidence and etiology of
hypercalcemia in patients hospitalized at the Department of Nephrology of the Warsaw Military Institute, as well as to evaluate its impact on renal function.
MATERIALS AND METHODS: In this cross-sectional study patients admitted to the Nephrology Department of the Warsaw Military Institute between January 2017 and December 2018 were retrospectively screened for presence of HCM, defined as total
calcium level or corrected
calcium level in case of
hypoalbuminemia >10.2 mg/dl, measured at least twice. Each patient's medical history as well as other laboratory findings were subsequently analyzed in order to establish the etiology of
hypercalcemia.
RESULTS: Among 3062 hospitalisations (1993 patients) at The Department, 96 patients had elevated
calcium level of which 36 were identified as hypercalcemic (1,81%). Median
calcium level was 11.9 mg/dl (IQR: 11.25-13.46) with 22.24 mg/dl being the maximum observed value.
Malignancy and drugs having hypercalcemizing effect were the most common etiologies identified, both being found in 9 cases (25%). Other causes of HCM included
sarcoidosis,
multiple myeloma (analyzed separately from other
malignancies), PHPT and hypercalcemic hypocalciuria. In 7 cases HCM etiology could not be established, it therefore remained idiopathic.
Acute kidney injury (AKI) developed in 20 patients (56%), in this group serum
calcium levels were significantly higher than in non-AKI patients (median: 12.85 mg/dl (IQR:11.82-14.65) vs 11.25 mg/dl (IQR:10.75-11.93); p=0.0039). Additionally,
chronic kidney disease (CKD) patients presented significantly lower
calcium values than non-CKD patients (median: 11.47 mg/dl (IQR: 10.8-12.6) vs 13.01 mg/dl (IQR:11.9-16.08; p=0.0131).
CONCLUSIONS: