Muldowney WP, Mazbar SA
Rolaids-yogurt syndrome: A 1990s version of milk-alkali
syndrome
Am J Kidney Dis
(Feb) 27:270-272 1996

Milk-alkali syndrome is characterized by hypercalcemia, alkalosis, and
renal failure and is classically due to consumption of large amounts
of calcium carbonate and dairy products. A 35-year-old bulimic woman
was hospitalized for fatigue, nausea, constipation, and confusion.
She had been taking 4 Rolaids tablets daily (each tablet containing
500 mg calcium carbonate) plus two 8-oz cups of yogurt daily to
prevent osteoporosis. Daily dietary calcium intake was estimated to
be 1.7 grams. The serum calcium and creatinine levels were 16 and 3.6
mg/dl, respectively, and the serum bicarbonate was 43 meq/l.
She was treated with physiologic saline and cessation of Rolaids and
yogurt consumption, after which the serum calcium and creatinine
levels improved to 10 and 1.8, respectively, and the alkalosis
resolved within 1 week. Since milk-alkali syndrome does not occur in
the absence of some degree of underlying renal failure, it is
postulated that this patient had chronic prerenal failure due to
vomiting prior to the ingestion of antacids. (David J
Leehey, M.D., Loyola University School of Medicine)