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These cases have in common minor changes in preparations leading to significant adverse events. In two cases, excipient changes were the only changes identified in the patients' regimen. In all cases, cessation of the offending calcium preparation and treatment with IV rehydration led to a return to baseline creatinine levels. Communicating to patients the importance of consistency in how calcium and vitamin D supplements are taken is crucial in preventing adverse effects. Prescribers should be aware of excipient changes and that these are not always clinically insignificant.<\/jats:p>","DOI":"10.1177\/0036933019877338","type":"journal-article","created":{"date-parts":[[2019,10,15]],"date-time":"2019-10-15T03:06:07Z","timestamp":1571108767000},"page":"32-37","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Small changes in calcium replacement therapy triggering hypercalcaemia and rising creatinine \u2013 a case series"],"prefix":"10.1177","volume":"65","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5695-5549","authenticated-orcid":false,"given":"Luis Loureiro","family":"Harrison","sequence":"first","affiliation":[{"name":"Registrar in Renal Medicine, Queen Elizabeth University Hospital, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alison","family":"Crooks","sequence":"additional","affiliation":[{"name":"Pharmacist, Dumfries and Galloway Royal Infirmary, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Kelly","sequence":"additional","affiliation":[{"name":"Consultant in Renal Medicine, Dumfries and Galloway Royal Infirmary, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fiona","family":"Green","sequence":"additional","affiliation":[{"name":"Consultant in Diabetes and Endocrinology, Dumfries and Galloway Royal Infirmary, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thalakunte","family":"Muniraju","sequence":"additional","affiliation":[{"name":"Consultant in Renal Medicine, Dumfries and Galloway Royal Infirmary, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2019,10,15]]},"reference":[{"key":"bibr1-0036933019877338","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1038\/kisup.2012.1","volume":"2","author":"Kellum JA","year":"2012","journal-title":"Kidney Int Suppl"},{"key":"bibr2-0036933019877338","doi-asserted-by":"publisher","DOI":"10.1186\/cc5713"},{"key":"bibr3-0036933019877338","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.01451005"},{"key":"bibr4-0036933019877338","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.2010030255"},{"key":"bibr5-0036933019877338","doi-asserted-by":"publisher","DOI":"10.1080\/08998280.2013.11928954"},{"key":"bibr6-0036933019877338","doi-asserted-by":"publisher","DOI":"10.3390\/nu5124880"},{"key":"bibr7-0036933019877338","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2265.2005.02383.x"},{"key":"bibr8-0036933019877338","unstructured":"Electronic Medicines Compendium. 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