From the Research
Milk alkali syndrome is a condition that requires immediate discontinuation of calcium and alkali sources, and treatment with intravenous fluids and monitoring of electrolytes, with consideration of bisphosphonates or calcitonin in severe cases, as supported by the most recent study 1.
Diagnosis and Treatment
Milk alkali syndrome is characterized by hypercalcemia, metabolic alkalosis, and kidney dysfunction, typically caused by excessive consumption of calcium and absorbable alkali from calcium carbonate antacids or supplements. The syndrome can lead to severe hypercalcemia, acute renal failure, and metastatic calcification if not treated promptly.
Pathophysiology and Clinical Importance
The pathophysiology of milk alkali syndrome involves a vicious cycle where increased calcium intake raises blood calcium levels, leading to reduced kidney function, which further elevates calcium levels and worsens alkalosis, as described in 2.
Prevention and Management
Prevention involves limiting calcium supplement intake to recommended daily allowances (1000-1200mg daily for adults) and using non-calcium containing antacids when needed for gastric symptoms, as suggested by 3. Key points to consider in the management of milk alkali syndrome include:
- Discontinuation of offending calcium and alkali sources
- Intravenous fluid rehydration with normal saline
- Monitoring of electrolytes until calcium levels normalize
- Consideration of bisphosphonates or calcitonin in severe cases
- Importance of detailed history in diagnosis, as highlighted in 4
- Recognition of the syndrome as a major cause of hypercalcemia among non-end-stage renal disease inpatients, as reported in 5