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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 .
Hypercalcemia
Hypercalcemia means you have too much calcium in your blood.
Loss of kidney function
Chronic kidney disease is the slow loss of kidney function over time. The main job of the kidneys is to remove wastes and excess water from the body...
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).
Osteoporosis
Osteoporosis is a disease in which bones become fragile and more likely to break (fracture).
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:
- Back, middle of the body, and low back pain in the kidney area (related to kidney stones)
- Confusion, strange behavior
- Constipation
- Depression
- Excessive urination
- Fatigue
-
Irregular heartbeat (
arrhythmia
)
Arrhythmia
An arrhythmia is a disorder of the heart rate (pulse) or heart rhythm. The heart can beat too fast (tachycardia), too slow (bradycardia), or irregul...
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- Other problems that can result from kidney failure
Exams and Tests
Calcium deposits within the tissue of the kidney ( nephrocalcinosis ) may be seen on:
Nephrocalcinosis
Nephrocalcinosis is a disorder in which there is too much calcium deposited in the kidneys. It is common in premature babies.
- X-rays
-
CT scan
CT scan
A computed tomography (CT) scan is an imaging method that uses x-rays to create pictures of cross-sections of the body. Related tests include:Abdomin...
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Ultrasound
Ultrasound
Ultrasound uses high-frequency sound waves to make images of organs and structures inside the body.
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Other tests used to make a diagnosis may include:
-
Electrolyte
levels
Electrolyte
Electrolytes are minerals in your blood and other body fluids that carry an electric charge. Electrolytes affect how your body functions in many ways...
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Electrocardiogram (
ECG
)
ECG
An electrocardiogram (ECG) is a test that records the electrical activity of the heart.
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Kidney function
Kidney function
Kidney function tests are common lab tests used to evaluate how well the kidneys are working. Such tests include:BUN (Blood urea nitrogen) Creatinin...
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Blood gas
Blood gas
Blood gases are a measurement of how much oxygen and carbon dioxide are in your blood. They also determine the acidity (pH) of your blood.
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Blood calcium
level
Blood calcium
The calcium blood test measures the level of calcium in the blood. This article discusses the test to measure the total amount of calcium in your blo...
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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 .
Dialysis
Dialysis treats end-stage kidney failure. It removes harmful substances from the blood when the kidneys cannot. This article focuses on peritoneal d...
Possible Complications
The most common complications include:
- Calcium deposits in tissues (calcinosis)
- Kidney failure
-
Kidney stones
Kidney stones
A kidney stone is a solid mass made up of tiny crystals. One or more stones can be in the kidney or ureter at the same time.
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When to Contact a Medical Professional
Contact your health care provider if:
- You take a lot of calcium supplements or you often use antacids that contain calcium, such as Tums. You may need to be checked for milk-alkali syndrome.
- You have any symptoms that might suggest kidney problems.
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 1.5 grams of calcium per day unless instructed by your provider.
References
Ferri FF. Milk-alkali syndrome. In: Ferri FF, ed. Ferri's Clinical Advisor 2016 . Philadelphia: PA Elsevier; 2016:803.e2-e3.
Smogorzewski MJ, Stubbs JR, Yu ASL. Disorders of calcium, magnesium, and phosphate balance. In: Skorecki K, Chertow GM, Marsden PA, Taal MW, Yu ASL, eds. Brenner and Rector's The Kidney . 10th ed. Philadelphia, PA: Elsevier; 2016:chap 19.
Review Date: 10/13/2015
Reviewed By: Walead Latif DO, nephrologist, Medical Director of Fresenius Vascular Care, and Clinical Assistant Professor of Rutgers Medical School, Newark, NJ. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.
