Milk-alkali syndrome

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Definition

  • Hypercalcemia due to increased calcium intake in the setting of renal failure

Background

  • 3rd most common cause of hypercalcemia, after hyperparathyroidism and malignancy

Clinical Features

  • Often due to heavy use of calcium containing antacids
  • headache, confusion, dizziness, poor appetite, psychosis, dry mouth, constipation

Laboratory Evaluation

  • High calcium
  • Alkalosis
  • Normal or high serum phosphate
  • Low serum PTH
  • Normal serum 25(OH)D
  • Normal or low 1,25(OH)D

Management

  • Hydration
  • Avoidance of calcium / alkali intake
  • Hospitalization for IV hydration in severe cases
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