Milk-alkali syndrome medical therapy

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Shakiba Hassanzadeh, MD[2]

Treatment of milk-alkali syndrome is mostly supportive and mainly includes the withdrawal of the offending agent, hydration, and intravenous volume expansion. However, other treatments such as therapy with calcium supplements (in temporary hypocalcemia) and hemodialysis (in acute or chronic irreversible renal insufficiency) may be required.

• Treatment of milk-alkali syndrome is mostly supportive, and with early diagnosis and therapy, renal function may return to normal.^[1][2]

• The main treatment of milk-alkali syndrome includes:
  • Withdrawal of the offending agent.
  • Hydration and intravenous volume expansion.

• The above treatments usually resolve the symptoms and abnormalities in milk-alkali syndrome (hypercalcemia, alkalosis and renal insufficiency).^[1][2]

• Additional treatments that may be required include:^[1][2]
  • Calcium supplements may be needed since during therapy temporary hypocalcemia may occur.
  • In hypercalcemic crisis, treatment with intravenous furosemide, pamindronate, and hydrocortisone have been reported to decrease calcium.

Acute or chronic irreversible renal insufficiency may require renal replacement with dialysis.^[1][2]

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