What is the definitive treatment approach for a patient diagnosed with severe hypercalcemia?

Severe hypercalcemia, a condition that can present with various symptoms including nausea, vomiting, confusion, and arrhythmias, requires prompt and effective management. The definitive treatment approach often begins with aggressive hydration, typically using intravenous fluids to help dilute the calcium in the blood, encourage renal excretion of excess calcium, and prevent complications associated with decreased kidney function.

Hydration is crucial because it helps restore normal kidney function, allowing for urinary excretion of calcium. This immediate management can alleviate symptoms and prevent further complications.

While calcitonin, surgery, and bisphosphonates can also play roles in the treatment of hypercalcemia depending on the underlying cause—such as hyperparathyroidism or malignancy—hydration is typically the first-line response in acute cases of severe hypercalcemia. Subsequently, other therapies may be employed based on the patient's specific condition and the response to initial hydration.