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Milk-alkali syndrome

Calcium-alkali syndrome; Cope syndrome; Burnett syndrome; Hypercalcemia; Calcium metabolism disorder

Milk-alkali syndrome is a condition in which there is a high level of calcium in the body (hypercalcemia). This causes a shift in the body's acid/base balance toward alkaline (metabolic alkalosis). As a result, there can be a loss of kidney function.

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Causes

Milk-alkali syndrome is almost always caused by taking too many calcium supplements, usually in the form of calcium carbonate. Calcium carbonate is a common calcium supplement. It is often taken to prevent or treat bone loss (osteoporosis). Calcium carbonate is also an ingredient found in antacids (such as Tums).

A high level of vitamin D in the body, such as from taking supplements, can worsen milk-alkali syndrome.

Calcium deposits in the kidneys and in other tissues can occur in milk-alkali syndrome.

Symptoms

In the beginning, the condition usually has no symptoms (asymptomatic). When symptoms do occur, they can include:

Exams and Tests

Calcium deposits within the tissue of the kidney (nephrocalcinosis) may be seen on:

Other tests used to make a diagnosis may include:

Treatment

In severe cases, treatment involves giving fluids through the vein (by IV). Otherwise, treatment involves drinking fluids along with reducing or stopping calcium supplements and antacids that contain calcium. Vitamin D supplements also need to be reduced or stopped.

Outlook (Prognosis)

This condition is often reversible if kidney function remains normal. Severe prolonged cases may lead to permanent kidney failure requiring dialysis.

Possible Complications

The most common complications include:

When to Contact a Medical Professional

Contact your health care provider if:

Prevention

If you use calcium-containing antacids often, tell your provider about digestive problems. If you are trying to prevent osteoporosis, do not take more than 1.2 grams (1200 milligrams) of calcium per day unless instructed by your provider.

Related Information

Peptic ulcer

References

Bringhurst FR, Demay MB, Kronenberg HM. Hormones and disorders of mineral metabolism. In: Melmed S, Auchus RJ, Goldfine AB, Koenig RJ, Rosen CJ, eds. Williams Textbook of Endocrinology. 14th ed. Philadelphia, PA: Elsevier; 2020:chap 29.

DuBose TD. Metabolic alkalosis. In: Gilbert SJ, Weiner DE, eds. National Kidney Foundation Primer on Kidney Diseases. 7th ed. Philadelphia, PA: Elsevier; 2018:chap 14.

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Review Date: 10/8/2019  

Reviewed By: Walead Latif, MD, Nephrologist and Clinical Associate Professor, Rutgers Medical School, Newark, NJ. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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