The milk-alkali syndrome (MAS) is a triad of hypercalcemia, metabolic alkalosis, and
renal failure, which is a consequence of high intake of calcium and absorbed alkaline
salts. The syndrome presents with various onsets of hypercalcemia and, if untreated,
may cause renal failure. An 83-year-old man was referred to our nephrology outpatient
clinic because of persistently high serum calcium levels and renal insufficiency.
Previous investigations could not evaluate the cause of hypercalcemia. Finally, it
turned out that the patient had been drinking 1.5-2.0 l of thermal water daily with
considerable calcium content for years. Cessation of thermal water consumption resulted
in the normalization of all parameters and clinical signs, indicating that the cause
of MAS in this case was an unusual factor, i.e., the consumption of excessive amounts
of thermal water.
