Hypercalcemia in the Critically Ill Patient

Hypercalcemia is now frequently recognized in hospitalized patients, including those who are critically ill. Hypercalcemia in critically ill patients may be life threatening or an indication of an underlying but unsuspected disease process. All of the common causes of hypercalcemia can occur in the critically ill patient and are reviewed here. As in the general patient population, the two most common causes are probably malignant disease and primary hyperparathyroidism. Hypercalcemia is now readily reversible in most patients, particularly when the underlying pathophysiologic mechanisms responsible are recognized, and it should be treated actively.