Hypercalcaemia

Abstract

Abstract Calcium homeostasis is maintained by the equilibrium among renal excretion, bone resorption, and intestinal absorption of calcium. Hypercalcaemia, which develops when the renal calcium overload exceeds its capacity to reabsorb calcium. Hyperparathyroidism is one of the most common causes of hypercalcaemia in free-living individuals, whereas hypercalcaemia of malignancy is the second cause of hypercalcaemia and the most common in hospitalized patients. The principal challenge in the evaluation of hypercalcaemia is distinguishing parathyroid hormone-related hypercalcaemia from other causes. Symptoms generally, but not always, correlate with the severity of hypercalcaemia and time course. The management of hypercalcaemia should be addressed at the underlying cause/mechanisms. When hypercalcaemia in moderate to severe the aim is also and most importantly directed to decrease hypercalcaemia, by increasing renal calcium excretion and decreasing bone resorption and intestinal calcium absorption. Severe hypercalcaemia represents an emergency and treatment is urgently required.