Hipercalcemia e lesão renal aguda causadas por abuso de um composto veterinário parenteral contendo vitaminas A, D e E

Rocha, Paulo Novis; Santos, Caroline Sancho; Ávila, Maria Olinda Nogueira; Neves, Camila Zander; Bahiense-Oliveira, Marilia

doi:10.1590/s0101-28002011000400013

Cited by 20 publications

(11 citation statements)

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“…6,7 This practice is essentially aesthetic and is not considered anabolic because there is no growth of muscle tissue, but muscle swelling. 1 The recommended dietary allowance for vitamin D in healthy adults is 600 IU, 8 and a much higher intake is required for toxicity. According to most reports, the toxicity threshold is around 10,000 to 40,000 UI a day.…”

Section: Discussionmentioning

confidence: 99%

“…12 Despite presenting a serum retinol level in the upper limit of the reference range, most vitamin A is stored in the liver and the patient had ingested about 7,500,000UI per month (250,000 UI per day), with a high probability of causing toxicity. 1 The use of anabolic steroids has also been associated with nephrotoxicity, although with a different clinical presentation. Focal segmental glomerulosclerosis with marked proteinuria was reported after a bodybuilding regimen consisting of dietary supplements, testosterone and growth hormone.…”

Section: Discussionmentioning

confidence: 99%

“…A few similar cases have been reported, mostly from Brazil. [1][2][3][4][5] Reports regarding this practice are scarce on scientific literature, although extensively covered in the lay press and bodybuilding websites.…”

Section: Discussionmentioning

confidence: 99%

“…Among many substances, the veterinary supplement ADE -which contains high doses of vitamin A, D and E -has been increasingly used due to its oily vehicle that induces local edema, enhancing muscle volume. [1][2][3][4][5] Here we report the case of a young man who presented with hypercalcemia and acute kidney injury following ADE injection.…”

Section: Introductionmentioning

confidence: 95%

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Hypercalcemia and acute renal insufficiency following use of a veterinary supplement

Ronsoni¹,

Santos²,

Colombo³

et al. 2017

Jornal Brasileiro De Nefrologia

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A previously healthy 24 yo male presented with a two-month history of epigastric pain, nausea, vomiting, fatigue and malaise. He reported abuse of different substances, including an injectable veterinary vitamin compound, which contains high doses of vitamin A, D and E, and an oily vehicle that induces local edema and enhances muscle volume. Serum creatinine was 3.1 mg/dL, alanine transaminase 160 mg/dL, aspartate transaminase 11 mg/dL, total testosterone 23 ng/dL, 25-OH-vitamin D >150 ng/ mL (toxicity >100), 1,25-OH-vitamin D 80 pg/mL, vitamin A 0.7 mg/ dL, parathormone <3 pg/mL, total calcium 13.6 mg/dL, 24-hour urinary calcium 635 mg/24h . A urinary tract ultrasound demonstrated signs of parenchymal nephropathy. The diagnosis was hypercalcemia and acute renal failure secondary to vitamin D intoxication. He was initially treated with intravenous hydration, furosemide and prednisone. On the fifth day of hospitalization a dose of pamidronate disodium was added. The patient evolved with serum calcium and renal function normalization. Thirty days later he presented normal clinical and laboratory tests, except 25-OH-vitamin D that was persistently increased (107 ng/mL), as it may take several months to normalize. This case report is a warning of the risks related to the use of veterinary substances for aesthetics purposes. abstRactKeywords: hypercalcemia; renal insufficiency; veterinary drugs; vitamin D.Um paciente de 24 anos do sexo masculino, previamente hígido, apresentou-se com uma história de dois meses de dor epigástrica, náuseas, vômitos, fadiga e mal-estar. Ele relatava abuso de diferentes substâncias, incluindo um composto vitamínico veterinário injetável contendo altas doses de vitamina A, D e E, e um veículo oleoso que induz edema local com aumento de volume muscular. A creatinina sérica estava 3,1 mg/ dL, alanina transaminase 160 mg/dL, aspartato transaminase 11 mg/dL, testosterona total 23 ng/dL, 25-OH-vitamina D > 150 ng/mL (toxicidade > 100), 1,25-OH-vitamina D 80 pg/mL, vitamina A 0,7 mg/dL, paratormônio < 3 pg/ mL, cálcio total 13,6 mg/dL, cálcio urinário de 24h 635 mg/24h (VR 42-353). Uma ultrassonografia do trato urinário demonstrou sinais de nefropatia parenquimatosa. O diagnóstico foi hipercalcemia e insuficiência renal aguda secundária a intoxicação por vitamina D. Ele foi tratado inicialmente com hidratação intravenosa, furosemida e prednisona. No quinto dia de hospitalização uma dose de pamidronato dissódico foi adicionada. O paciente evoluiu com normalização do cálcio sérico e da função renal. Trinta dias depois ele apresentou testes clínicos e laboratoriais normais, exceto a 25-OH-vitamina D que estava persistentemente elevada (107 ng/mL), já que ela pode demorar vários meses para normalizar. Este relato de caso é um alerta aos riscos relacionados ao uso de substâncias veterinárias para fins estéticos. ResumoPalavras-chave: drogas veterinárias; hipercalcemia; insuficiência renal; vitamina D.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 95%

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Hypercalcemia and acute renal insufficiency following use of a veterinary supplement

Ronsoni¹,

Santos²,

Colombo³

et al. 2017

Jornal Brasileiro De Nefrologia

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“…Therefore, there is evident loss of water, leading to hypovolemia, which causes AKI and concomitantly deteriorates the hypercalcemia. So, there is a continuous circle of hypercalcemia causing hypovolemia-induced AKI and vice versa (49)(50)(51). Moreover, hypercalcemia and hypercalciuria can lead to deposition of calcium, thus causing nephrolithiasis and renal calcification, which can cause the development of AKI (49)(50)(51).…”

Section: Vitamin D Toxicity Induced Akimentioning

confidence: 99%

Vitamin D and Acute Kidney Injury: A Two-Way Causality Relation and a Predictive, Prognostic, and Therapeutic Role of Vitamin D

2021

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Background: Acute kidney injury (AKI) constitutes a multi-factorially caused condition, which significantly affects kidney function and can lead to elevated risk of morbidity and mortality. Given the rising scientific evidence regarding vitamin D's (VitD's) multisystemic role, the connection between AKI and VitD is currently being studied, and the complex relation between them has started to be unraveled.Methods: A systematic review had been conducted to identify the pathogenetic relation of VitD and AKI and the potential role of VitD as a biomarker and therapeutic–renoprotective factor.Results: From 792 articles, 74 articles were identified that fulfilled the inclusion criteria. Based on these articles, it has been found that not only can VitD disorders (VitD deficiency or toxicity) cause AKI but, also, AKI can lead to great disruption in the metabolism of VitD. Moreover, it has been found that VitD serves as a novel biomarker for prediction of the risk of developing AKI and for the prognosis of AKI's severity. Finally, animal models showed that VitD can both ameliorate AKI and prevent its onset, suggesting its renoprotective effect.Conclusion: There is a complex two-way pathogenetic relation between VitD disorders and AKI, while, concomitantly, VitD serves as a potential novel predictive–prognostic biomarker and a treatment agent in AKI therapy.

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Bone and Muscle

Wang

Bonewald

et al. 2017

Molecular and Integrative Toxicology

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Hipercalcemia e lesão renal aguda causadas por abuso de um composto veterinário parenteral contendo vitaminas A, D e E

Cited by 20 publications

References 20 publications

Hypercalcemia and acute renal insufficiency following use of a veterinary supplement

Hypercalcemia and acute renal insufficiency following use of a veterinary supplement

Vitamin D and Acute Kidney Injury: A Two-Way Causality Relation and a Predictive, Prognostic, and Therapeutic Role of Vitamin D

Bone and Muscle

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