29th December 2024

Overview of malignant hypercalcaemia

Malignant hypercalcaemia occurs in approximately 1 in 5 cancer patients and of all inpatients admitted with hypercalcaemia, cancer represents the most common cause.

Hypercalcaemia can be life threatening, resulting in progressive hypovolaemia, renal impairment, cognitive impairment and arrhythmia. It is, therefore, essential to detect and treat hypercalcaemia early, especially if free/adjusted Ca ≥ 3.0 mmol/L.

Note – a proportion of serum calcium is bound to albumin, and low serum albumin levels may result in a falsely low total calcium reading. Adjusted calcium (based on albumin) must be calculated to estimate free calcium levels.