Cardella C J, Birkin B L, Rapoport A
Clin Nephrol. 1979 Dec;12(6):285-90.
The role of dialysis in the treatment of patients with severe hypercalcemia is uncertain. The fourteen previously reported cases of hypercalcemia treated with either peritoneal or hemodialysis have been reviewed. Two additional patients treated with hemodialysis are described in this report. Because the use of large volumes of intravenous fluids was contraindicated, each of the patients received a low calcium bath (0-1 mEq calcium per liter) hemodialysis for three and a half hours. After dialysis, the serum calcium fell to normal in both and remained normal thereafter with treatment of the underlying disease (multiple myeloma in one and vitamin D intoxication in the other). Hemodialysis can clear up to 682 mg of calcium per hour as compared to 124 mg per hour for peritoneal dialysis and 82 mg per hour with forced saline diuresis. Low calcium bath hemodialysis is indicated when the presence of renal and/or cardiac failure prevents the administration of large volumes of intravenous fluids to hypercalcemic patients.
透析在重症高钙血症患者治疗中的作用尚不确定。我们回顾了之前报道的14例接受腹膜透析或血液透析治疗的高钙血症病例。本报告描述了另外2例接受血液透析治疗的患者。由于禁忌使用大量静脉补液，每位患者均接受了低钙浴（每升含0 - 1毫当量钙）血液透析3.5小时。透析后，两位患者的血清钙均降至正常水平，此后在治疗基础疾病（1例为多发性骨髓瘤，另1例为维生素D中毒）的过程中一直保持正常。与腹膜透析每小时清除124毫克钙、强制盐水利尿每小时清除82毫克钙相比，血液透析每小时可清除高达682毫克钙。当肾功能和/或心力衰竭导致无法给高钙血症患者大量静脉补液时，宜采用低钙浴血液透析。
