Milk-alkali syndrome

Definition 
Milk-alkali syndrome is an acquired condition caused by high levels of calcium (hypercalcemia) and a shift in the body’s acid/base balance towards alkaline (metabolic alkalosis).

Causes, incidence, and risk factors 

Milk-alkali syndrome is caused by excessive consumption of milk (which is high in calcium) and soluble alkali-like antacids, especially sodium bicarbonate (Baking soda) over a prolonged period of time.

Calcium deposits in the kidneys and other tissues may occur in milk-alkali syndrome. This condition is exacerbated by the consumption of vitamin D, which is frequently added to milk bought at the supermarket. In the past, milk-alkali syndrome was often a side effect of treating peptic ulcer disease. It is rarely seen today, because of newer, better medications available for teatment of ulcers.

Symptoms  
The condition is often asymptomatic (shows no symptoms). When symptoms do occur, they are often related to complications, like kidney problems. These include: back and loin pain (related to Kidney stones), excessive urination, and other problems that can result from Kidney failure.

Signs and tests 

Calcium deposits within the tissue of the kidney (nephrocalcinosis) may be seen on X-rays, computer tomography (CT scans), or ultrasound.

Blood chemistries, blood gas tests, and serum calcium tests in patients with a history of chronic alkali antacid use or high milk consumption are often necessary to make the diagnosis.

Treatment  
Treatment involves reducing or eliminating milk and antacid consumption. If severe Kidney failure has occurred, the damage may be irreparable.

Expectations (prognosis) 
This condition is often reversible if kidney function remains normal. Severe prolonged cases may lead to permanent renal failure, requiring dialysis.

Complications 
The most common complications include: Kidney stones, calcinosis (calcium deposits in tissues), and potentially, Kidney failure.

Calling your health care provider 

     
  • You have any symptoms which might suggest kidney problems.  
  • You drink large amounts of milk and you use antacids frequently.

Prevention 

Milk-alkali syndrome is now very uncommon because non-antacid treatments for Indigestion, gastric ulcers, and peptic ulcer disease have replaced most excessive antacid use.

If you do use large quantities of antacids, don’t drink large amounts of milk, and tell your doctor about your digestive problems.

Johns Hopkins patient information

Last revised: December 8, 2012
by Brenda A. Kuper, M.D.

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