Acute renal failure calcitonin

Giving intravenous phosphate is probably the fastest and surest way to reduce serum calcium, but it is a hazardous procedure if not done properly. Intravenous phosphate should be used only after other methods of treatment (bisphosphonates, calcitonin, and saline diuresis) have failed to control symptomatic hypercalcemia. Phosphate must be given slowly (50 mmol or 1.5 g elemental phosphorus over 6-8 hours) and the patient switched to oral phosphate (1-2 g/d elemental phosphorus, as one of the salts indicated below) as soon as symptoms of hypercalcemia have cleared. The risks of intravenous phosphate therapy include sudden hypocalcemia, ectopic calcification, acute renal failure, and... 

Several new reports on the use of human, porcine or salmon calcitonin in the management of Paget s disease of bone have appeared. Biochemical and clinical improvement (especially reduction of pain) is obvious although not always complete 4 5, 6 ). Addition of diphosphonate to the treatment with calcitonin improved the biochemical results (8 ). Side effects (nausea, vomiting, transient facial flushing or diarrhoea) usually subside after a few days of treatment (4 ). The possibility of acute renal failure due to salmon calcitonin is raised by the report of a single case (7 ). 

Elevated concentrations of calcitonin or increased responsiveness to stimulation have also been reported in acute and chronic renal failure, hypercalcemia, hypergastrinemia and other gastrointestinal disorders, pulmonary disease, and severe iUness. ... 

Acutely, the use of saline infusion accompanied by administration of loop diuretics enhances urinary calcium excretion. Calcitonin, mithramycin and corticosteroids decrease calcium movement from bone. Reduced intake of calcium and corticosteroids decrease intestinal absorption of calcium. Short-term hemodialysis or peritoneal dialysis is effective for the rapid removal of calcium from the blood in crisis situations, especially in patients with renal failure or congestive heart failure. Prolonged hemodialysis, however, is not a therapeutic solution because of its impracticality and high complication rate. 

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