Hypervitaminosis A in two hemodialysis patients.

We present two cases of hemodialysis patients developing vitamin A toxicity related to excessive consumption of nutritional supplements containing large quantities of vitamin A. In one patient, severe hypercalcemia was the lone presenting sign; in the other, hypercalcemia was associated with unusual neurologic manifestations. We will discuss the reason why hemodialysis patients are at special risk for the development of hypervitaminosis A and review the mechanism leading to the associated hypercalcemia.