How Are Hypercalcemia And Renal Failure Related?

Hypercalcemia is a condition when there are elevated levels of calcium in the blood. This condition can have different kind of negative effects on the body, such as renal failure. Once there is kidney damage, it is not possible to reverse it.

One of the most abundant mineral in our body is calcium ⁽¹⁾. Calcium is required for different types of important functions in the body, such as maintenance of the structure of the tooth and bone, nerve signaling and muscle movement.

There is about greater than 99% of calcium present in the body is stored in the bones with the remaining calcium present in blood in different forms ⁽¹⁾. There are different hormones in the body which are responsible for regulating the levels of blood calcium to prevent any health issues.

Rarely, there can be increased calcium levels in the body, which can cause kidney problems and can potentially lead to renal failure. In some cases, renal failure can increase the levels of calcium in the blood also. In this article, we will discuss the relationship between increased calcium levels (hypercalcemia) and renal (kidney) failure.

What is Hypercalcemia?

Excessive calcium in the blood is known as hypercalcemia.

The levels of calcium in the blood are usually in the range of 8.5 to 10.5 mg per deciliter ⁽²⁾. If the calcium levels are more than this, then it often means that you are suffering from hypercalcemia.

What are the Symptoms of Hypercalcemia?

When the blood calcium levels are more than 12 mg/dL, then the symptoms of hypercalcemia are seen and can potentially include ⁽³⁾: lethargy, fatigue, increased urine output, pain in the bones, increased thirst, kidney stones and digestive symptoms, such as: pain in the abdomen; decreased appetite; constipation; nausea and vomiting.

Hyperparathyroidism is one of the most common causes of hypercalcemia where body produces excessive parathyroid hormone (PTH) and cancer. These two combined are responsible for about 80 to 90% diagnosis of hypercalcemia ⁽⁴⁾.

Other lesser common causes of hypercalcemia are:

Certain medications, such as some lithium or diuretics.

Granulomatous disease, such as tuberculosis or sarcoidosis.

Excess of vitamin A, vitamin D or calcium supplementation

What is Renal (Kidney) Failure?

Kidney failure occurs when the kidneys are not able to filter the excess fluid and waste from the blood. This condition can be chronic or acute. Acute renal failure is an abrupt episode of renal failure which develops over duration of hours to days ⁽⁵⁾. Kidney failure from chronic kidney disease (CKD) can develop over a longer period of time.

Some of the symptoms that are commonly seen in both types of renal failure are: weakness, fatigue, shortness of breath, reduced urination, swelling (edema) the ankles, feet or legs and nausea or vomiting.

People suffering from chronic kidney disease experience the following symptoms in addition: low appetite; itchy skin; difficulty sleeping; unintentional weight loss and cramping of the muscles.

Certain medications, acute disease or injury and blockage of the urinary tract are some examples that can lead acute renal failure.

Hypertension and diabetes are two of the most common causes of chronic kidney disease.

Can Hypercalcemia Cause Renal Failure?

Yes, hypercalcemia can cause kidney damage and lead to renal failure. Increased calcium in the blood reduces the ability to filter by the kidneys. Increased levels of blood calcium cause this mineral to accumulate in the tissue of the kidneys and lead to a condition known as nephrocalcinosis ⁽⁶⁾. With time, this can cause damage and lead to renal failure.

Hypercalcemia also increases the risk of kidney stones, which can block the flow of urine and increase the risk of infection; where both of these factors can contribute to kidney damage.

Is it Possible for Kidney Failure to Cause Hypercalcemia?

Yes, kidney or renal failure can lead to hypercalcemia and this can occur as a result of bone and mineral disorder in chronic kidney disease ⁽⁷⁾.

Individuals suffering from chronic kidney disease will produce less of the hormone, which is responsible for absorption of the calcium by the body resulting in reduced levels of calcium in the blood.

When the blood calcium levels are low, then the body releases PTH, which is responsible for transporting the calcium from the bones into the bloodstream resulting in increased levels of calcium in the blood.

Additionally, as the vitamin D and calcium levels may be low in people suffering from chronic kidney disease, so they can take supplements. Sometimes calcium over-supplementation can lead to hypercalcemia ^{(8, 9)}.

When should you see a doctor?

Renal failure and hypercalcemia can both cause significant health problems and likely death if it is not treated. So, when suffering from symptoms consistent with renal failure or hypercalcemia, then consult your doctor immediately. For diagnosing, blood, urine, and imaging tests are done to find out the cause of the symptoms. After a diagnosis is made, an appropriate treatment plan can be formulated.

What is the Treatment for Renal Failure and Hypercalcemia?

Dialysis is done for treating hypercalcemia as well as renal failure ⁽¹⁰⁾. Dialysis is a procedure where a machine helps the kidneys in filtering the blood and excess fluids from the body along with restoring the balance of minerals, such as calcium.

Other potential treatments can also be done depending on the cause of hypercalcemia, the type of renal failure, patient’s age and general health. Other treatment options include:

Calcitonin is given which is a medication to reduce the levels of calcium in the blood.

Saline infusion is given to increase the urinary output and to flush out the excess calcium

People with hyperparathyroidism will be advised to remove the parathyroid gland.

Steroids are given if hypercalcemia is caused by excessive vitamin D.

Bisphosphonates are given for people having hypercalcemia that is caused by cancer.

If any supplements or medications are contributing to hypercalcemia, then they are stopped or weaned off.

What is the Prognosis of People Having Hypercalcemia and Renal Failure?

Treatment can help in reversing the acute renal failure caused by hypercalcemia. However, in case of acute renal failure, there is also an increased risk of developing chronic kidney disease in the future ⁽¹¹⁾. It is possible to manage hypercalcemia; however, the kidney damage cannot be reversed after it has occurred.

The two types of treatment for kidney failure in individuals suffering from late stage chronic kidney disease consist of dialysis and kidney transplant. The treatment which the doctor chooses depends on factors, such as patient’s age, general health and preference.

Are There Any Additional Complications Caused By Hypercalcemia?

Other than kidney problems and kidney failure, hypercalcemia can also cause complications such as: pancreatitis, stomach ulcers, depression, irregular heart rhythm and nervous system problems, like memory problems, confusion, numbness and tingling. 

Conclusion

Increased levels of calcium in the blood are known as hypercalcemia and this usually occurs as an effect of hyperparathyroidism or cancer. Damage to the kidneys can occur because of hypercalcemia and can potentially cause renal failure.

Having chronic kidney disease can also lead to development of hypercalcemia. This is because of the body’s response to reduced calcium levels in the blood. Excessive calcium or vitamin D supplements can also cause hypercalcemia.

If someone is suffering from renal failure and hypercalcemia, then treatment will consist of dialysis along with other treatment. Treatment helps in managing the symptoms of hypercalcemia, however, after kidney damage has occurred then it is not possible to reverse it.

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Also Read:

• Why Does Kidney Failure Occur?
• How Can We Prevent Kidney Failure?
• Symptoms of Kidney Failure & Why Does Kidney Failure Occur?
• How Long Can You Live With Kidney Failure On Dialysis?
• Is There A Link Between Multiple Myeloma and Kidney Failure?