2003 Volume 36 Issue 1 Pages 67-71
A 26-year-old man developed acute renal failure due to severe rhabdomyolysis following heat stroke during a half marathon in Cambodia. After two hemodialysis sessions in Singapore and a third hemodialysis session at the emergency unit of a hospital near Tokyo International Airport, he was transferred to Tohoku University Hospital. On admission, he showed persistent oliguria and severe uremia as indicated by serum creatinine (8.1mg/dL), creatinine phosphokinase (2, 128IU/L) and myoglobin (11, 700ng/mL). Hemodiafiltration was performed three times, then his renal function began to improve gradually with an increase in urine volume. However, hypercalcemia (serum Ca 16.2mg/dL) developed during the diuretic phase. Hydration treatment with administration of prednisolone and elcatonin was started. Ten days after the start of this treatment, the serum calcium level returned normal (serum Ca 10.1mg/dL).
Although there have been few Japanese case reports of hypercalcemia during recovery from acute renal failure associated with rhabdomyolysis, particular individuals are thought to be at high risk for hypercalcemia. Therefore, the level of calcium must be carefully checked during recovery from acute renal failure due to rhabdomyolysis.
