Clinical review 51: Management of hypercalcemia

Abstract

Hypercalcemia is a very common electrolyte abnormality that is most often seen as a mild elevation in the setting of asymptomatic primary hyperparathyroidism. The hypercalcemia is usually less than 11.2 mg/dL and does not call for specific or vigorous approaches to management. However, more marked elevations in the serum calcium are also seen and call for a more specific approach to management. When the serum calcium is only moderately elevated, the therapeutic approach should be tempered by clinical assessments about the presence of symptoms and the underlying etiology. When the serum calcium is markedly elevated, a more targeted therapeutic approach is called for which now is independent of the presence of symptoms and usually of the underlying etiology. Considerations of hypercalcemia in these three different ranges will tailor the therapeutic approach to the clinical setting.