Division of Nephrology, Department of Medicine, Taoyuan General Hospital, Taoyuan, Taiwan.
Am J Emerg Med. 2012 Oct;30(8):1665.e5-7. doi: 10.1016/j.ajem.2011.09.023. Epub 2011 Nov 17.
Severe hypercalcemia in the course of renal failure is quite unusual. If unrecognized, irreversible inexorable attrition of renal function takes place, carrying a substantial morbidity and mortality. In particular, acute nonobstructive pyelonephritis is barely considered in the primary differential diagnosis of renal failure. Without urinary obstruction, kidney hypoperfusion, or exposure to nephrotoxic agents, a significant decline in glomerular filtration rate generally does not occur. We report a case with severe hypercalcemia after acute renal failure caused by fulminating bacterial pyelonephritis. To obviate unnecessary intervention, preserve organ function, and achieve better outcomes, clinicians should not miss this entity.
肾功能衰竭过程中出现严重高钙血症并不常见。如果未被识别，肾功能将不可逆转地逐渐恶化，导致较高的发病率和死亡率。特别是，急性非梗阻性肾盂肾炎在肾功能衰竭的主要鉴别诊断中几乎不被考虑。在没有尿路梗阻、肾脏低灌注或接触肾毒性药物的情况下，肾小球滤过率通常不会显著下降。我们报告了一例暴发性细菌性肾盂肾炎引起的急性肾衰竭后出现严重高钙血症的病例。为了避免不必要的干预，保护器官功能，实现更好的结果，临床医生不应忽视这种情况。
