Denosumab aumentó la densidad mineral ósea pero causó fluctuaciones marcadas del calcio sérico en un paciente sometido a diálisis peritoneal

Serum calcium then overshot, peaking at 13.8 mg/dL on day 29; therapy was de-escalated and calcium stabilized. This case highlights that while daily dialysate calcium exposure in PD may buffer early hypocalcemia, concurrent escalation of dialysate calcium, vitamin D therapy, and calcium supplementation can precipitate overshoot hypercalcemia. Frequent monitoring and staged, stepwise prescription changes during the first month after denosumab are essential. Standardized PD-specific post-denosumab calcium management protocols © 2026. The Author(s), under exclusive licence to Japanese Society of