Vitamin D Toxicity Managed with Peritoneal Dialysis.
Level 4 - case-series / case-control
Single clinical case report
PubMed 34258083 · doi:10.1155/2021/9912068
What was done
A case report described a 75-year-old man presenting with acute kidney injury, pancreatitis, and severe hypercalcemia secondary to vitamin D toxicity. Standard medical therapies (aggressive intravenous fluid hydration, intravenous diuretics, calcitonin, bisphosphonates, and corticosteroids) were initially administered. Because calcium levels rose whenever medical therapy was interrupted, 10 sessions of peritoneal dialysis were conducted to manage the hypercalcemia and reduce vitamin D levels.
What was found
Vitamin D toxicity was confirmed with a level greater than 200 ng/dL (reference: 20-50 ng/mL) by liquid chromatography-mass spectroscopy. Following 10 sessions of peritoneal dialysis, hypercalcemia resolved and 25-hydroxyvitamin D levels trended downward as measured by dilution. Specific baseline and final numerical values for serum calcium were not reported in the abstract.
Why it matters
This report highlights peritoneal dialysis as a feasible therapeutic modality for refractory hypercalcemia due to severe vitamin D toxicity when standard medical management fails to provide lasting resolution.
Limits
This is a single-patient case report (n = 1) with no control or comparative group. Specific numerical values for initial and final serum calcium, dialysate clearance rates, and long-term renal outcomes were not provided in the abstract.
Cited by
- supports Published case reports show that vitamin D toxicity requiring hospitalization occurs at blood levels of 200 to 250 ng/mL and above.