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In a healthy physiology, extracellular calcium levels are maintained within a tight range through the actions of parathyroid hormone, vitamin D and the calcium sensing receptor. [1] Disorders in calcium metabolism can lead to hypocalcemia, decreased plasma levels of calcium or hypercalcemia, elevated plasma calcium levels.
The natural, active form of vitamin D is calcitriol (1,25-dihydroxycholecalciferol). This molecule and other naturally occurring forms of vitamin D, including its precursors and metabolites, have been modified to synthesize pharmaceuticals with potentially greater, or selective, therapeutic actions. [1] [2] [3] [4]
effective in hypercalcemia due to malignancy with elevated vitamin D levels (many types of malignancies raise the vitamin D level). [22] also effective in hypervitaminosis D and sarcoidosis; dialysis usually used in severe hypercalcaemia complicated by kidney failure. Supplemental phosphate should be monitored and added if necessary
Eldecalcitol is an analog of calcitriol, the active form of vitamin D. [1]Commonly used in Japan for the treatment of osteoporosis. [2] Osteoporosis is a common bone disease among the older generation, with an estimated prevalence of over 200 million people. [2]
Mapping of several bone diseases onto levels of vitamin D (calcidiol) in the blood [6] Normal bone vs. osteoporosis. Vitamin D deficiency is typically diagnosed by measuring the concentration of the 25-hydroxyvitamin D in the blood, which is the most accurate measure of stores of vitamin D in the body.
Vitamin D toxicity, or hypervitaminosis D, is the toxic state of an excess of vitamin D. The normal range for blood concentration of 25-hydroxyvitamin D in adults is 20 to 50 nanograms per milliliter (ng/mL).
There are a number of causes of hypercalciuria including genetic (idiopathic), primary hyperparathyroidism, immobilization, pagets disease, Multiple Myeloma, Calcium excess, Vitamin D excess/increased sensitivity, drug-induced hypercalciuria, sarcoidosis, hyperthyroidism, Cushing's disease, and renal tubular acidosis.
If the underlying cause of the hypocalcemia can be addressed, the hyperparathyroidism will resolve. In people with chronic kidney failure, treatment consists of dietary restriction of phosphorus; supplements containing an active form of vitamin D, such as calcitriol, doxercalciferol, paricalcitol; and phosphate binders, which are either calcium-based and non-calcium based.