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Title:Hiperkalcemija pri bolniku z rakom
Authors:ID Matos, Erika (Author)
ID Pajk, Bojana (Author)
Files:.pdf PDF - Presentation file, download (45,54 KB)
MD5: 650BA730EE641E7D92E5D31623AB60F2
PID: 20.500.12556/dirros/9b1cf16b-d392-4095-b0ac-0a6a0579de46
 
Language:Slovenian
Typology:1.04 - Professional Article
Organization:Logo OI - Institute of Oncology
Abstract:Hiperkalcemija je najpogostejša presnovna motnja, ki ogroža bolnika z rakom. Najpogostejša je pri solidnih rakih (rak pljuč, dojke), pogosta pa je tudi pri hematoloških malignomih (zlasti pri multiplem mielomu). Glavni vzrok hiperkalcemije zaradi rakave bolezni je povečana resorpcija kosti in nezadostno izločanje kalcija prek ledvic. Najpogostejši sta osteolitična in humoralna hiperkalcemija. Osteolitična je posledica večje kostne resorpcije, njeni mediatorji pa so različni citokini na mestu zasevka. Humoralna hiperkalcemija je posledica izločanja paratiroidnemu hormonu podobnega peptida (PTH-rP). Prvi znaki hiperkalcemije so žeja, poliurija, slabost, splošna utrujenost in zaprtje. Pri vrednosti serumskega kalcija nad 3,0 mmol/l se začnejo pojavljati znaki prizadetosti osrednjega živčevja, poveča se nevarnost za srčne aritmije, pri dalj časa trajajoči hiperkalcemiji lahko pride do okvare ledvic. Uspešno zdravljenje temelji na intenzivni hidraciji s fiziološko raztopino, vzpodbujanju izločanja kalcija z diuretiki po doseženi normovolemiji in zaviranju kostne resorpcije z bisfosfonati (zolendronatom, pamiodronatom ali ibandronatom). Vendar pa bomo hiperkalcemijo dolgotrajno uspešno obvladovali le, če bomo sočasno zdravili rakavo bolezen, ki je privedla do nje. Če zdravljenje maligne bolezni ni bilo uspešno, tudi zdravljenje hiperkalcemije ni smiselno.
Publication status:Published
Publication version:Version of Record
Year of publishing:2009
Number of pages:str. 45-46
Numbering:Letn. 13, št. 1
PID:20.500.12556/DiRROS-8719 New window
UDC:616-006
ISSN on article:1408-1741
URN:URN:NBN:SI:doc-6FBGQNWA
COBISS.SI-ID:25709785 New window
Copyright:by Authors
Note:BSDOCID145261;
Publication date in DiRROS:31.08.2018
Views:3917
Downloads:897
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Record is a part of a journal

Title:Onkologija
Shortened title:Onkologija
Publisher:Onkološki inštitut
ISSN:1408-1741
COBISS.SI-ID:65324032 New window

Licences

License:CC BY 4.0, Creative Commons Attribution 4.0 International
Link:http://creativecommons.org/licenses/by/4.0/
Description:This is the standard Creative Commons license that gives others maximum freedom to do what they want with the work as long as they credit the author.
Licensing start date:31.08.2018

Secondary language

Language:English
Title:Hypercalcemia in Cancer Patients
Abstract:Hypercalcemia is the most common life-threatening metabolic disorder in cancer patients. Solid tumors (such as lung or breast cancer) as well as certain hematologic malignancies (particularly multiple myeloma) are most frequently associated with hypercalcemia. The fundamental cause of cancer–induced hypercalcemia is increased bone resorbtion and inadequate renal clearance. The most common types of hypercalcemia are osteolytic and humoral. The osteolytic hypercalcemia results in increased local osteoclastic bone resorbtion mediated by different cytokines. Humoral hypercalcemia is caused by secretion of parathyroid hormone-related protein (PTH-rP). Early symptoms of hypercalcemia are thirst, polyuria, nausea, vomiting, fatigue and constipation. Signs and symptoms of central nerve system impairment and a higher risk of cardiac arrhythmias appear when serum calcium level rises beyond 3,0 mmol/l. Renal function deterioration could evolve in long-lasting hypercalcemia. The cornerstones of successful antihypercalcemic therapy are rehydration with normal saline, calciuresis with the use of loop diuretics after normovolemia has been restored and inhibition of bone resorbtion with the use of intravenous bisphosphonates (zolendronate, pamiodronate or ibandronate). However, long-term efficacy of cancer-induced hypercalcemia will be successful only if it is accompanied with the effective treatment of underlying malignant disease. When all available cancer therapies have failed, also treatment of hypercalcemia is of no sense.


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