Catastrophic hypercalcemia as a technical complication in home hemodialysis

Life-threatening hypercalcemia in dialysis patients is very unusual. We present a case where life-threatening hypercalcemia in a home hemodialysis patient resulted from a technical mistake. A 46-year-old woman, on home nocturnal hemodialysis, presented to the emergency room with history of altered sensorium, vomiting and sweating, which started 1 h after initiation of dialysis the previous night. Serum calcium was 6.5 mmol/L. She improved with 10 h of low-calcium hemodialysis. Investigation revealed that the drain port of the reverse osmosis machine was connected to the dialysis machine and the product water was connected to the drain leading to acute hypercalcemia.