Fritschi Barbara C, Trachsler Johannes, Varga Zsuzsanna, Binet Isabelle, Fehr Thomas
Division of Nephrology , University Hospital Zürich , Switzerland.
Clinic for Nephrology , Stadtspital Waid Zürich , Switzerland.
NDT Plus. 2010 Dec;3(6):551-4. doi: 10.1093/ndtplus/sfq144. Epub 2010 Jul 27.
Hypocalcaemia often occurs in patients after parathyroidectomy (PTX) due to hypoparathyroidism and/or hungry bone syndrome. To avoid hypocalcaemia, patients are substituted with large doses of calcium and vitamin D. Here, we present four patients, who developed acute renal failure with hypercalcaemia and/or histologically confirmed nephrocalcinosis after PTX due to oversubstitution with vitamin D analogues and calcium. As a consequence, serum and urinary calcium should be closely monitored after PTX, and calcium and vitamin D substitution should be continuously adapted to avoid not only hypocalcaemia but also nephrocalcinosis and hypercalcaemic renal failure.
甲状旁腺切除术后（PTX）的患者常因甲状旁腺功能减退和/或饥饿骨综合征而发生低钙血症。为避免低钙血症，会给患者大量补充钙和维生素D。在此，我们报告4例患者，他们在PTX后因维生素D类似物和钙补充过量而出现高钙血症和/或经组织学证实的肾钙质沉着症，并发展为急性肾衰竭。因此，PTX后应密切监测血清和尿钙水平，并且应持续调整钙和维生素D的补充量，以避免不仅发生低钙血症，还能避免肾钙质沉着症和高钙血症性肾衰竭。
