The clinical interpretation of hypercalcemia may be difficult in patients with end stage renal disease and multiple myeloma. Interpretation of an abnormal serum calcium concentration requires simultaneous evaluation of factors such as serum phosphorus, protein, alkaline phosphatase and parathyroid hormone levels, which are significantly altered in both renal failure and multiple myeloma. We herein present an end-stage renal disease patient on hemodialysis therapy with post-operative hypoparathyroidism, who developed otherwise asympto-matic progressive hypercalcemia. The case is challenging in the point that multiple myeloma was diagnosed in the course of chronic renal disease during the clinical work up for the evaluation of asymptomatic hypercalcemia. We also review the literature about the diagnosis and treatment of multiple myeloma coexisting with renal failure.

The clinical interpretation of hypercalcemia may be difficult in patients with end stage renal disease and multiple myeloma. Interpretation of an abnormal serum calcium concentration requires simultaneous evaluation of factors such as serum phosphorus, protein, alkaline phosphatase and parathyroid hormone levels, which are significantly altered in both renal failure and multiple myeloma. We herein present an end-stage renal disease patient on hemodialysis therapy with post-operative hypoparathyroidism, who developed otherwise asympto-matic progressive hypercalcemia. The case is challenging in the point that multiple myeloma was diagnosed in the course of chronic renal disease during the clinical work up for the evaluation of asymptomatic hypercalcemia. We also review the literature about the diagnosis and treatment of multiple myeloma coexisting with renal failure.