Hypocalcaemia

Description

Medicine Treatment

Referral

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ICD-10 Code: E83.5 + (E20.0-1/E20.8-9)

DESCRIPTION

• Serum calcium (corrected for albumin) below the lower limit of normal.

Causes

• Renal failure.
• Hypoparathyroidism:
  • post neck surgery,
  • radiotherapy, or
  • idiopathic.
• Vitamin D related, (deficient intake, activation or action).
• Hypomagnesaemia.
• Malabsorption syndrome.

MEDICINE TREATMENT

Therapy is aimed at treating the underlying cause.

For acute hypocalcaemia with neurological problems and prolonged QT time on ECG:

• Calcium gluconate 10%, infusion, 20 mL in 100 mL dextrose 5% given over 20 minutes, with ECG monitoring.

AND

• Calcium gluconate 10%, infusion, 15 mg/kg (= wt [kg] X 1.7 mL) in 1000 mL sodium chloride 0.9% over 4 hours.  

LoE:III³²

For hypoparathyroidism:

• Alfacalcidol, oral, 1-3 mcg daily.

AND

• Calcium, elemental, oral, 500–1 500 mg daily in divided doses.

Correct magnesium deficiency if present.

Renal failure:

• See Chronic Kidney Disease (CKD).

REFERRAL

• If cause is uncertain.
• If hypoparathyroidism suspected and PTH analysis required as above.

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Standard Treatment Guidelines and Essential Medicines List for South Africa, Hospital Level, Adults 2024 Edition