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The predominant symptoms of hypercalcemia are abdominal pain, constipation, extreme thirst, excessive urination, kidney stones, nausea and vomiting. [3] [14] In severe cases where the calcium concentration is >14 mg/dL, individuals may experience confusion, altered mental status, coma, and seizure. [3] [14]
Patients suffering from low bone density, hypercalciuria, and stone formation should increase daily fluid consumption and focus on a low sodium and low protein diet. Reducing calcium intake to attempt to remedy elevated urine calcium has been shown to further progress bone loss without an effect on urine calcium loss. [4]
Hypercalcemia usually causes symptoms that lead to chronic dehydration, such as nausea, vomiting, anorexia, and nephrogenic diabetes insipidus (inability of the kidney to concentrate the urine). IV fluid rehydration allows the kidneys to excrete more calcium, and usually lowers the calcium level by 1–2 mg/dL. [22]
Careful dietary decisions should be taken since a deficient calcium intake diet accompanies the risk of excessive bone loss and can increase the absorption of dietary oxalates, found in many leafy greens and vegetables, which combine with calcium in the intestines, [29] and form oxalate kidney stones. [8]
Urine pH may be monitored to help prevent the formation of kidney stones or to avoid side effects of some drugs, [68] such as high-dose methotrexate therapy, in which crystals that cause kidney damage can form if the urine is acidic. [69] If microscopy is performed, knowing the pH of the sample helps to identify any crystals that might be ...
Milk-alkali syndrome (MAS), also referred to as calcium-alkali syndrome, is the third most common cause of elevated blood calcium levels (hypercalcemia). [2] [3] Milk-alkali syndrome is characterized by hypercalcemia, metabolic alkalosis, and acute kidney injury.
Some of the oxalate in urine is produced by the body. Calcium and oxalate in the diet play a part but are not the only factors that affect the formation of calcium oxalate stones. Dietary oxalate is found in many vegetables, fruits, and nuts. Calcium from bone may also play a role in kidney stone formation. Calcium phosphate: 10–20%
The most obvious cause is a kidney or systemic disorder, including amyloidosis, [2] polycystic kidney disease, [3] electrolyte imbalance, [4] [5] or some other kidney defect. [2] The major causes of acquired nephrogenic diabetes insipidus that produce clinical symptoms (e.g., polyuria) in the adult are lithium toxicity and high blood calcium.
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