What is the similarity between Hyperclcemia of malignancy and Diabetes insupidus? - USMLE Forums
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Old 05-27-2011
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Question What is the similarity between Hyperclcemia of malignancy and Diabetes insupidus?

How hypercalcemia of malignancy and nephrogenic diabetes has same pathophysiology?
I mean to say how they can cause renal tubular dysfunction by similar mechanism?
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Old 05-27-2011
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How does Hypercalcemia cause Nephrogenic Diabetes Insipidus?
• Decreased delivery of solute to the loop of Henle
• Inhibition of NaCl transport in the thick ascending limb
• Inhibition of vasopressin-mediated water permeability in the terminal collecting duct
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Old 05-27-2011
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Quote:
Originally Posted by struggle View Post
How hypercalcemia of malignancy and nephrogenic diabetes has same pathophysiology?
I mean to say how they can cause renal tubular dysfunction by similar mechanism?
Deposition of Calcium Phosphate is favored by basic environments. Therefore under conditions of hypercalcemia, calcium deposition in tissues with relatively basic environments can lead to tissue damage.

For example, in the kidney, Bicarbonate is reabsorbed so calcium deposition is favored. This can lead to Nephrogenic DI as the calcium deposition reduces sensitivity to ADH.

Similarly since acid is released in the lumen of the stomach, Bicarbonate is released into the basolateral side so calcium deposits in the stomach as well. This can lead to mucosal damage and Peptic Ulcer Disease.

Deposition of calcium in the pancreas occurs because bicarbonate is released into the pancreatic ducts. This can lead to pancreatitis.
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