Thyssen E P, Hou S H, Alverdy J C, Spiegel D M
Department of Medicine, Michael Reese Hospital, Chicago, IL.
Am J Kidney Dis. 1990 Nov;16(5):491-4. doi: 10.1016/s0272-6386(12)80066-7.
A case of unusually severe soft tissue calcification with temporary loss of limb function in a patient with rhabdomyolysis-induced acute renal failure (ARF) is described. A large dose of intravenous (IV) calcium was administered early in the hospital course to treat hypocalcemia, and hemodialysis, when initiated, was with a 1.75-mmol/L calcium dialysate. This case illustrates the danger of administering calcium supplementation and raises questions about the use of normal to high dialysate calcium concentration in the early stages of rhabdomyolysis-induced oliguric ARF. Calcium supplementation should be reserved for patients with clear clinical signs of hypocalcemia and dialysate calcium should be adjusted to prevent excessive positive calcium balance.
