Got Calcium? Welcome to the Calcium-Alkali Syndrome

Patel, Ami M.; Goldfarb, Stanley

doi:10.1681/asn.2010030255

Cited by 84 publications

(67 citation statements)

References 32 publications

(55 reference statements)

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“…The syndrome was associated with the ingestion of large quantities of milk and absorbable alkali to treat peptic ulcer disease [178]. Nowadays, this syndrome is called calcium-alkali syndrome (CAS) [179]. The incidence of CAS in children is not clear.…”

Section: Alkali Administration (Non-chloride-depletion Metabolic Alkamentioning

confidence: 99%

Drug-induced acid-base disorders

et al. 2014

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The incidence of acid-base disorders (ABDs) is high, especially in hospitalized patients. ABDs are often indicators for severe systemic disorders. In everyday clinical practice, analysis of ABDs must be performed in a standardized manner. Highly sensitive diagnostic tools to distinguish the various ABDs include the anion gap and the serum osmolar gap. Drug-induced ABDs can be classified into five different categories in terms of their pathophysiology: (1) metabolic acidosis caused by acid overload, which may occur through accumulation of acids by endogenous (e.g., lactic acidosis by biguanides, propofol-related syndrome) or exogenous (e.g., glycol-dependant drugs, such as diazepam or salicylates) mechanisms or by decreased renal acid excretion (e.g., distal renal tubular acidosis by amphotericin B, nonsteroidal antiinflammatory drugs, vitamin D); (2) base loss: proximal renal tubular acidosis by drugs (e.g., ifosfamide, aminoglycosides, carbonic anhydrase inhibitors, antiretrovirals, oxaliplatin or cisplatin) in the context of Fanconi syndrome; (3) alkalosis resulting from acid and/or chloride loss by renal (e.g., diuretics, penicillins, aminoglycosides) or extrarenal (e.g., laxative drugs) mechanisms; (4) exogenous bicarbonate loads: milk-alkali syndrome, overshoot alkalosis after bicarbonate therapy or citrate administration; and (5) respiratory acidosis or alkalosis resulting from drug-induced depression of the respiratory center or neuromuscular impairment (e.g

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Section: Alkali Administration (Non-chloride-depletion Metabolic Alkamentioning

confidence: 99%

Drug-induced acid-base disorders

et al. 2014

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“…23 Hypercalcemia causes acute kidney injury by several mechanisms, including decreasing renal blood flow by afferent arteriolar vasoconstriction, volume depletion, and tubular obstruction. 7 The degree of our patient's renal failure was significant as normal pregnancy induces a state of glomerular hyperfiltration and a low serum creatinine in normal pregnancy. Her creatinine elevation to 2.1 mg/dl reflected a large decrease in glomerular filtration rate.…”

Section: Discussionmentioning

confidence: 70%

“…6 To reflect this change in etiology, some have proposed changing the name of this condition to "calcium-alkali syndrome." 7 In pregnant women, measured total serum calcium is decreased because of hypoalbuminemia but ionized calcium remains normal. 8,9 Hypoalbuminemia in pregnancy is due to increases in total body water.…”

Section: Discussionmentioning

confidence: 99%

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Hypercalcemia in Pregnancy: A Case of Milk-Alkali Syndrome

et al. 2011

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Milk-alkali syndrome is a rare cause of hypercalcemia characterized by the triad of hypercalcemia, renal insufficiency, and metabolic alkalosis that results from the overconsumption of calcium containing products. In the setting of pregnancy where there is a physiologic increase in calcium absorption, milkalkali syndrome can be potentially life threatening. We report a case of a 26-year-old woman in her second trimester of pregnancy who presented with 2 weeks of flank pain, nausea, vomiting, anorexia, headache, and lightheadedness. The history revealed consumption of a large quantity of milk, calcium carbonate antacid, and calcium-containing prenatal vitamins. Her symptoms and hypercalcemia resolved with intravenous fluids and a loop diuretic. With the increased use of calcium carbonate for peptic ulcer disease, gastroesophageal reflux disease, and osteoporosis, milk-alkali syndrome has experienced a resurgence and must be considered in the differential diagnosis of hypercalcemia. In this clinical vignette we review the literature on milk-alkali syndrome in pregnancy and discuss important diagnostic and therapeutic considerations when managing the pregnant patient with hypercalcemia.KEY WORDS: hypercalcemia; milk-alkali syndrome; pregnancy. J Gen Intern Med 26(8):

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“…This has contributed to the resurgence of the milk-alkali syndrome, recently renamed the "Rolaids-yogurt" or "calcium-alkali" syndrome [34,35]. The calciumalkali syndrome is characterized by progressive hypercalcemia, systemic alkalosis, and renal insufficiency and is the third most common cause of hospitalization for hypercalcemia (after hyperparathyroidism and hypercalcemia of malignancy) [34,35]. tative advice included the following.…”

Section: Calcium and Vitamin D Intake Among Men: The Recommended And mentioning

confidence: 99%

Calcium and Vitamin D Supplementation During Androgen Deprivation Therapy for Prostate Cancer: A Critical Review

Datta

Schwartz

2012

The Oncologist

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After completing this course, the reader will be able to:1. Describe the prevalence of bone loss with androgen deprivation therapy for prostate cancer.2. Discuss the possible increased risk of cardiovascular disease and of advanced prostate cancer with high calcium intake.This article is available for continuing medical education credit at CME.TheOncologist.com. CME CME ABSTRACTBackground. Loss of bone mineral density is an unintended consequence of androgen deprivation therapy in men with prostate cancer. Supplementation with calcium and/or vitamin D in these men seems logical and is advocated by many lay and professional groups. Methods. We reviewed guidelines for calcium and vitamin D supplementation and the results of clinical trials of calcium and vitamin D supplementation on bone mineral density in men with prostate cancer undergoing androgen deprivation therapy.Results. Whether supplementation of men undergoing androgen deprivation therapy with calcium and/or vitamin D results in higher bone mineral density than no supplementation has not been tested. The results of 12 clinical

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Got Calcium? Welcome to the Calcium-Alkali Syndrome

Cited by 84 publications

References 32 publications

Drug-induced acid-base disorders

Drug-induced acid-base disorders

Hypercalcemia in Pregnancy: A Case of Milk-Alkali Syndrome

Calcium and Vitamin D Supplementation During Androgen Deprivation Therapy for Prostate Cancer: A Critical Review

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