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May 1978

Hypercalcemic Nephropathy

Author Affiliations

From the Medical and Research Services, Veterans Administration Center, San Juan, and the Department of Physiology, University of Puerto Rico School of Medicine, San Juan.

Arch Intern Med. 1978;138(5):777-779. doi:10.1001/archinte.1978.03630290069022

Hypercalcemia a frequent electrolyte disturbance, which is most commonly caused by cancer and parathyroid hormone (PTH) disturbances. The mechanisms by which cancer produces hypercalcemia are: (1) direct bone involvement, and (2) the production of substances that may accelerate bone resorption. In addition to PTH-like material, two such substances are prostaglandins and the so-called osteoclast activating factor, which is a material isolated from malignant cell lines, particularly lymphomas and multiple myeloma.1-3 Excessive secretion of PTH by parathyroid adenomas, hyperplasia, or carcinoma causes hypercalcemia by bone resorption, a mechanism potentiated by the active metabolite of vitamin D, 1,25-dihydroxycholecalciferol.4-5 Excessive formation or enhanced sensitivity to this compound, which in addition to potentiating PTH, increases gastrointestinal calcium reabsorption (as in sarcoidosis), is probably also a common cause of hypercalcemia. It is not within the scope of the present review to provide an extensive list of causes of hypercalcemia. Rather, we emphasize that

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