Hypercalcemia with progression to Acute Kidney Injury (AKI) after daily use of 120,000 UI of Vitamin D: a case report

Abstract

Alternative therapies, such as the use of vitamin D in high daily doses, are increasingly common and available for clinical practice in the treatment of autoimmune diseases. Its use requires caution due to the active role of vitamin D in immunomodulation and calcium absorption by the body. Here we describe a case report about a condition of hypercalcemia with evolution to acute renal failure after using high daily doses of vitamin D as recommended by the alternative Coimbra Protocol. A twenty-one-years old, Caucasian female patient, presented with acute renal failure after continuous and daily use of 120,000 IU of cholecalciferol, according to medical recommendation. She has evolved with hypercalcemia and digestive symptoms due to intoxication by hypervitaminosis D. Due to refractory hypercalcemia despite the measures imposed, zoledronic acid was added to the therapy, which proved to be effective in resolving the case. The treatment of autoimmune diseases based on the Coimbra Protocol lacks studies that prove its effectiveness. Evidence is undoubtedly needed to prove the benefits and establish the risks to which patients may be exposed when using high daily doses of vitamin D.