Appropriate treatment of hypercalcemia depends upon the symptom severity, serum calcium level, renal function, and overall health status of the patient. Tumor stage and oncologic prognosis are also important and must be taken into consideration when formulating a management plan. Laboratory investigations include a CBC, serum electrolytes, ionized and total serum calcium, albumin, BUN, and serum creatinine. Serum magnesium should also be measured since hypercalcemia commonly induces renal magnesium wasting through actions exerted at the loop of Henle. Assays for PTHrP are available; however, the utility of this test is questionable at present. Perhaps in cases without a definitive diagnosis of malignancy, PTHrP and PTH levels should both be evaluated.
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