Recurrent acute kidney injury with outcome in chronic kidney disease due to hypercalcemia because of prolonged use of dihydrotachysterol

Authors

  1. Burdenko Main Military Clinical Hospital, Russian Federation, Russian Federation
  2. Russian Medical Academy of continuous postgraduate education, Moscow, Russian Federaton, Russian Federation, Russian Federation
  3. Moscow Medical - Social Institute named after Friedrich Haass, Moskva, Russian Federation

https://doi.org/10.35571/RMSJ.2019.2.007

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Abstract

Introduction. Hypoparathyroidism after hyroidectomy is treated with oral calcium and vitamin-D supplements. Everyday prolonged use of calcium and vitamin D medications can lead sometimes to hypercalcemia that can cause Akute Kidney Injury (AKI) and Arterial Hypertension. We report on a clinical case of a man patient with postoperative hypoparathyroidism who presented with hypercalcemia, AKI and Chronic Kidney Disease (CKD) as a result of prolonged treatment with Dihydrotachysterol and calcium medications. Сlinical case. A male patient, 59 y.o., 11 years ago underwent total thyroidectomy, since that time was daily medicated with l-thyroxine 125-150 mcg, dihydrotachysterol 15 drops (approx. 0,62 mg), calcium in different forms without monitoring the blood and urine levels. He had high arterial pressure up to 200/120 mm Hg, treated with amlodipine 10 mg daily. After 5 years he took onemonth treatment with non-steroidal antiinflammatory drugs for pain relief because of a rib fracture. That time he underwent first AKI with full recovery. After 5 years a few AKI recurred with hypercalcemia. Dihydrotachysterol and calcium were cancelled, but since that time patient kept on getting non-prescribed Dihydrotachysterol and calcium in the same doses. After 1 year more in relapse series a puncture biopsy of the kidney showed nephrocalcinosis, chronic interstitial nephritis and CKD (С4А3) was diagnosed. The patient was treated successfully by dis-continuation of the above drugs, intravenous fluid administration and enhancement of calcium renal excretion. The patient is currently free of complaints for about 3 months. Сonclusion. It is important for clinicians to monitor calcium and 25-OH-D levels in blood serum during the prolonged treatment with calcium and vitamin D medications to prevent a hypercalcemia that can lead to AKI, CKD and other sever complications.

Keywords

Hypoparathyroidism, Vitamin D, Dihydrotachysterol, Overdose, Hypercalcemia, Hypervitaminosis D, Acute Kidney Injury, Nephrocalcinosis, Chronic Kidney Disease

Для цитирования:

Борисов А.Г., Корабельников Д.И., Романов В.П. Рецидивирующие острые повреждения почек с исходом в хроническую болезнь почек вследствие гиперкальциемии при длительном приеме дигидротахистерола. Российский медико-социальный журнал. 2019;1(2):83-91. https://doi.org/10.35571/RMSJ.2019.2.007

For citation:

Borisov A., Korabelnikov D., Romanov V. Recurrent acute kidney injury with outcome in chronic kidney disease due to hypercalcemia because of prolonged use of dihydrotachysterol. Russian Medical and Social Journal. 2019;1(2):83-91. (In Russian) https://doi.org/10.35571/RMSJ.2019.2.007

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About the authors

  • Aleksey Borisov, Burdenko Main Military Clinical Hospital, Russian Federation, Russian Federation, Russian Medical Academy of continuous postgraduate education, Moscow, Russian Federaton, Russian Federation, Russian Federation

    Burdenko Main Military Clinical Hospital — Nephrology Unit, Head,MD

    Russian Medical Academy of continuous postgraduate education, Moscow, Russian Federaton — Department of General Medical Practice and Outpatient Therapy, Associate Professor

  • Daniil Korabelnikov, Moscow Medical - Social Institute named after Friedrich Haass, Moskva, Russian Federation

    Moscow Medical - Social Institute named after Friedrich Haass — Rector

  • Vadim Romanov, Burdenko Main Military Clinical Hospital, Russian Federation, Russian Federation

    Burdenko Main Military Clinical Hospital — Nephrology Unit, Head,MD

How to Cite

Recurrent acute kidney injury with outcome in chronic kidney disease due to hypercalcemia because of prolonged use of dihydrotachysterol. (2019). Russian Medical and Social Journal, 1(2), 83-91. https://doi.org/10.35571/RMSJ.2019.2.007
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ISSN (Print) 2658-7726 ISSN (Online) 2658-7718