The immobilization from acute spinal cord injury (SCI) stimulates osteoclastic bone resorption. This process results in calcium loss from the bones and hypercalciuria. Hypercalcemia results when the efflux of calcium is massive or the glomerular filtration rate of the kidneys is reduced.
The onset of hypercalcemia usually is insidious. The patient may present with vague and varied symptoms beginning several weeks after SCI. Clinicians should suspect hypercalcemia in high-risk groups. If untreated, patients may develop dehydration, personality changes, calcium oxalate nephrolithiasis, and renal failure. Treatment is aimed at early mobilization, hydration, and restoration of the balance between calcium excretion and resorption.
Synonyms and related keywords:
hypercalcemia, spinal cord injury , SPI, osteoclastic bone resorption, immobilization hypercalcemia, calcium loss, hypercalciuria, calcium oxalate nephrolithiasis, renal failure, parathyroid hormone, natriuresis, nephrogenic diabetes insipidus, polyuria, extracellular fluid contraction, polydipsia, urinary stones, nephrocalcinosis, immobilization after spinal cord injury
Teresa L Massagli, MD 2006