Calcium and Blood Pressure

Though the urinary hydroxyproline to creatinine ratio has been proposed as a useful indicator of bone breakdown in malignancy,1' we found no significant fall in this variable in patients whose rate of bone mineral resorption had clearly been decreased. The explanation is possibly that tissue other than bone continues to be broken down at a greatly increased rate, masking any fall produced from the decreased bone turnover.Of additional interest was the finding of quite profound hypomagnesaemia in some patients (as low as 0 3 mmol/l). This may simply result from an inability of the renal tubules to differentiate between divalent cations as the filtration of calcium increases. Though no patient had symptoms directly related to hypomagnesaemia, its role in the neuromuscular symptoms in concert with hypercalcaemia warrants further investigation.All patients obtained much relief of their distressing symptoms, and in a setting which is often preterminal the value of an effective agent which is free of side effects is self evident. We therefore now use APD 60 mg as a single infusion over eight hours along with adequate saline rehydration as the sole initial management of the hypercalcaemia of malignancy and give further APD when hypercalcaemia recurs or at regular intervals of three weeks to maintain normocalcaemia. Evidently other factors including the response to chemotherapy determine the eventual outcome.

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Calcium and Blood Pressure

Cited by 3 publications

References 4 publications

Indikationen für Calcium-Antagonisten

Indikationen für Calcium-Antagonisten

Parathyroid Hormone, Electrolytes, and Blood Pressure

Raised plasma intact parathyroid hormone concentrations in young people with mildly raised blood pressure

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