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Old 08-14-2011
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Default calcium metabolism doubt!

guys,
i read in uworld that both Primary hypothyroidism and Chronic renal failure cause low Ca2+ and high phosphate.

How can chronic renal failure do that. It causes vitamin D deficiency which causes low calcium and phosphate too and later there is Secondary hyperparathyroidism which causes Normal/low calcium and low phosphate.
I just don't understand how CRF causes low calcium and high phosphate?
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Old 08-14-2011
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Quote:
Originally Posted by cool_atomic View Post
guys,
i read in uworld that both Primary hypothyroidism and Chronic renal failure cause low Calcium and high phosphate.

How can chronic renal failure do that. It causes vitamin D deficiency which causes low calcium and phosphate too and later there is Secondary hyperparathyroidism which causes Normal/low calcium and low phosphate.
I just don't understand how CRF causes low calcium and high phosphate?
PTH's action on the kidney is that it reabsorbs calcium & loses Phosphate. So, hypoparathyroidism would lead to low Cacium & high Phosphate.

In CRF, there is dec. conversion of the vit. D to its active form leading to dec in both Calcium & Phosphate. This stimulates the release of PTH, which tries to inc the Serum Calcium by increasing Bone demineralization, releasing both Calcium & phosphate. But in CRF, the kidney is not functioning & is unable to get rid of the extra Phosphate. So as a result there is build up of Phosphate, explaining Inc Phosphate in CRF.
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busterbee (08-14-2011), cool_atomic (08-14-2011), Sadalssud (08-14-2011)



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