A patient with acute renal failure due to hypercalcemia associated with activated vitamin D3 ointment, who had undergone hemodialysis

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A man in his 60s had been treated for psoriasis vulgaris with activated vitamin D<SUB>3</SUB> (maxacalcitol) ointment and etretinate since 2006. In August 2010, he developed diarrhea, anorexia, and general fatigue. Under a diagnosis of viral enterocolitis, he underwent parenteral fluid therapy by a local physician. However, general fatigue persisted despite improving his diarrhea; therefore, he was admitted to our hospital. Since the serum creatinine level was 11.16mg/dL and potassium was at 8.1mEq/L with metabolic acidosis, hemodialysis was initiated. As he had been treated with maxacalcitol ointment for long periods, we therefore susupected acute renal failure due to hypercalcemia resulting from the maxacalcitol ointment, and so discontinued it. After five hemodialysis sessions and conservative management, his renal function improved to a serum creatinine level of 2.46mg/dL. Finally, this patient was discharged from our hospital with mild renal dysfunction. We should always consider that activated vitamin D<SUB>3</SUB> ointment may result in hypercalcemia and acute renal failure.