Managing mineral balance in end-stage renal disease.
نویسنده
چکیده
Calcium and phosphorus exist in a delicate balance in the body, with bone playing a central role in maintaining whole-body calcium–phosphorus homeostasis. The balance of phosphorus and calcium in healthy individuals is maintained through the complex interplay between parathyroid hormone (PTH) and 1,25-dihydroxyvitamin D3 (calcitriol). If serum calcium levels fall, PTH acts to increase renal reabsorption of calcium and bone dissolution, as well as increasing the conversion of vitamin D to calcitriol. Calcitriol increases calcium absorption in the small intestine, and also acts as a negative feedback on the production of PTH. As renal function declines and ultimately fails, the resulting hyperphosphataemia disrupts the balance between calcium, PTH and calcitriol. Disruptions in this balance lead to important pathology of bone and the cardiovascular system, as discussed by Malluche et al., and Goodman in this Supplement.
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ورودعنوان ژورنال:
- Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association
دوره 19 Suppl 1 شماره
صفحات -
تاریخ انتشار 2004