Nephrology Book

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Calcium

Aka: Calcium, Calcium Ion, Calcium Metabolism, Calcium Homeostasis
  1. See Also
    1. Serum Calcium
    2. Urine Calcium
    3. Hypercalcemia
    4. Hypocalcemia
    5. Calcium and Phophorus Metabolism in Chronic Kidney Disease
    6. Bone Physiology
    7. Osteoporosis
  2. Physiology
    1. Images
      1. CalciumHomeostasis.png
    2. Calcium is the most common mineral found in the human body
      1. Bones and Teeth
      2. Metabolic processes
        1. Enzyme modulator (when bound to calmodulin)
      3. Neuromuscular Function and Nerve Impulses
      4. Blood Clotting Pathway
      5. Cell Movement
    3. Total body Calcium distribution
      1. Skeleton: 98%
      2. Circulating: 2%
        1. Free or ionized Serum Calcium (active): 50%
        2. Albumin-bound Serum Calcium (inactive): 50%
    4. Parathyroid Hormone (PTH) modulates Serum Calcium (via Activated Vitamin D)
      1. PTH promotes renal activation of Vitamin D to 1,25-dihydroxycholecalciferol (activated Vitamin D)
        1. Calcium intestinal absorption is directly increased by 1,25-dihydroxycholecalciferol
          1. Intestinal Calcium absorption is the primary mechanism for regulating body Calcium
        2. Bone resorption increases with 1,25-dihydroxycholecalciferol
        3. Renal Distal convoluted tubule Calcium reabsorption increases with 1,25-dihydroxycholecalciferol
      2. PTH levels rise and fall inversely with Serum Calcium
        1. PTH rises in response to Low Serum Calcium (Hypocalcemia)
        2. PTH falls in response to High Serum Calcium (Hypercalcemia)
      3. PTH inhibits renal phosphate reabsorption
        1. Serum Phosphate would typically rise with Calcium reabsorption in gut, Kidneys and with bone resorption
        2. However, PTH's inhibition of renal phosphate reabsorption prevents Hyperphosphatemia
    5. Vitamin D effects vary by concentration
      1. Low concentrations of Vitamin D
        1. Promotes bone calcification
        2. Increases Calcium gastrointestinal absorption and renal reabsorption
        3. Persistent Vitamin D Deficiency may result in Rickets
      2. High concentrations of Vitamin D
        1. Functions in similar way to Parathyroid Hormone
        2. Increases bone resorption
    6. Other factors affecting Calcium levels (less significant than PTH and Vitamin D)
      1. Calcitonin
        1. Calcitonin increases bone mineralization
        2. Calcitonin decreases Serum Calcium
      2. Blood pH
        1. Acidosis promotes Hypercalcemia
          1. Decreased Calcium plasma protein binding (Calcium is displaced by excess Hydrogen Ion)
        2. Alkalosis promotes Hypocalcemia
          1. Increased Calcium plasma protein binding
          2. Hypoventilation (and associated alkalosis) may result in transient Tetany from Hypocalcemia
  3. Associated Conditions
    1. Hypercalcemia
    2. Hypocalcemia
    3. Rickets in children (Osteomalacia in Adults)
    4. Tetany
  4. References
    1. Goldberg (2014) Clinical Physiology, Medmaster, Miami p. 31

Disorder calcium (NOS) (C0302590)

Definition (CSP) condition in which there is a deviation or interruption in the processing of calcium in the body, its absorption, transport, storage, and utilization.
Concepts Pathologic Function (T046)
SnomedCT 267505006, 154752005
English calcium disorder, Calcium disorder, Calcium disorder (NOS), Disorder calcium (NOS), calcium disorders
Dutch calciumstoornis (NAO), calciumstoornis
French Troubles calciques SAI, Trouble calcique, Perturbation calcique SAI
German Erkrankung Kalzium (NNB), Kalziumerkrankung, Kalziumerkrankung (NNB)
Italian Disturbo del calcio, Disturbo del metabolismo del calcio (NAS)
Portuguese Alteração do cálcio NE, Alteração do cálcio
Spanish Trastorno del calcio, Trastorno del calcio (NEOM)
Japanese カルシウム代謝障害(NOS), カルシウムタイシャショウガイNOS
Czech Porucha vápníku (NOS), Porucha vápníku
Hungarian Calcium betegség, Calcium anyagcsere betegség (k.m.n.), Calcium eltérés (k.m.n.)
Sources
Derived from the NIH UMLS (Unified Medical Language System)


Calcium ion (C0596235)

Definition (NCI) The metabolically-active portion of calcium, not bound to proteins, circulating in the blood.
Definition (NCI_CRCH) Calcium ion requiring two electrons to return to its elemental state.
Definition (CSP) divalent cation essential in cellular signal transduction and the normal functioning of nerves and muscles; plays a role in blood coagulation and in many enzymatic processes.
Concepts Element, Ion, or Isotope (T196) , Pharmacologic Substance (T121)
English Ionized Calcium, Ca2+, Calcium Ion, Calcium ion, ion calcium, free calcium, calcium ions, calcium ion, CALCIUM CATION, Ca 2+, CA+2, Ca++, Calcium 2+, CA, Calcium cation, Calcium Cation, calcium cation, Free Calcium, Calcium Ions
Sources
Derived from the NIH UMLS (Unified Medical Language System)


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