ArticleCase reports in nephrology and dialysis
Management of Severe Hypercalcemia with Continuous Venovenous Hemodialysis and Regional Citrate Anticoagulation: A Case Report.
Article in Case reports in nephrology and dialysis. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
1 citing paper in PubMed.
- Hypercalcemia in intensive care unit: pathophysiological mechanisms and clinical implications.Intensive care medicine · 2026Article
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Authors and funding
3 authors.
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No grant is acknowledged in the PubMed record.
Abstract
Introduction: Severe hypercalcemia is a potentially life-threatening condition that often requires urgent medical intervention, especially when refractory to conventional treatments. Continuous renal replacement therapy (CRRT) with regional citrate anticoagulation (RCA) is a therapeutic option, although data on its use in hypercalcemia are limited. Case Presentation: We report the case of a 78-year-old woman who presented with severe hypercalcemia (4.89 mmol/L, corrected for albumin), ECG changes, muscle weakness, and acute kidney injury. She was unresponsive to standard treatments including crystalloids, diuretics, calcitonin, and bisphosphonates. Imaging revealed multiple lytic bone lesions and a mediastinal mass, with biopsy confirming diffuse large B-cell lymphoma. Continuous venovenous hemodialysis (CVVHD) with RCA was initiated after other therapies failed to lower calcium levels and symptoms persisted. Initial challenges with anticoagulation were resolved by increasing the citrate dose, along with an adapted calcium supplementation rate, leading to successful normalization of calcium levels within 30 h. Careful monitoring of post-filter calcium, systemic calcium and total-to-ionized calcium ratios, along with rapid dose adjustments, prevented complications such as hypocalcemia, citrate accumulation, and rebound hypercalcemia. The patient's calcium levels stabilized and she was transferred to a regular nursing ward to start oncological treatment. Conclusion: This case highlights the effectiveness of CVVHD with RCA in managing refractory hypercalcemia and underscores the importance of vigilant monitoring and individualized adjustments to prevent treatment-related complications.
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