급성 신부전을 동반한 부동화에 의한 고칼슘혈증성 신증 1예
Immobilization-Induced Hypercalcemic Nephropathy Associated with Acute Kidney Injury
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초록
본 증례는 부동화가 지속되는 상태의 환자에서 발생한 고칼슘혈증과 관련되어 급성신부전이 발생한 경우로, 드물기는 하지만 고칼슘혈증과 관련되어 급성 신부전이 발생할 수 있으며 글루코코르티코이드의 사용이 고칼슘혈증 및 급성 신부전 호전에 도움이 될 수 있을 것이라 생각된다.
Abstract
Hypercalcemia commonly occurs because of primary hyperparathyroidism and metastatic malignancies, such as multiple myeloma, breast cancer and lung cancer; these causes account for 90% of cases. The other causes of hypercalcemia are numerous, and immobilization is an under-appreciated etiology. The mechanisms underlying immobilization-induced hypercalcemia are uncertain. However, an overall increased osteoclastic bone resorption and decreased osteoblastic bone formation can induce hypercalciuria and hypercalcemia. Additionally, hypercalcemia can induce and be associated with acute kidney injury, but it is rarely reported in immobilization hypercalcemia. We report here a 58-year-old man with suspected immobilization hypercalcemia associated with acute kidney injury and treated successfully with glucocorticoids. (Korean J Med 2012;82:744-748)
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