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Diagnosis is generally based on a blood phosphate level exceeding 1.46 mmol/L (4.5 mg/dL). [1] Levels may appear falsely elevated with high blood lipid levels, high blood protein levels, or high blood bilirubin levels. [1] Treatment may include a phosphate low diet and antacids like calcium carbonate that bind phosphate. [1]
Though calcium is the most plentiful electrolyte in the body, a large percentage of it is used to form the bones. [14] It is mainly absorbed and excreted through the GI system. [ 14 ] The majority of calcium resides extracellularly, and it is crucial for the function of neurons , muscle cells , function of enzymes , and coagulation . [ 14 ]
Calcium is the most abundant mineral in the human body. [3] The average adult body contains in total approximately 1 kg, 99% in the skeleton in the form of calcium phosphate salts. [3] The extracellular fluid (ECF) contains approximately 22 mmol, of which about 9 mmol is in the plasma. [4]
Disorders of calcium metabolism occur when the body has too little or too much calcium. The serum level of calcium is closely regulated within a fairly limited range in the human body. In a healthy physiology, extracellular calcium levels are maintained within a tight range through the actions of parathyroid hormone , vitamin D and the calcium ...
Non-calcium-based phosphate binders, including lanthanum carbonate, form insoluble complexes with phosphates in food, thereby reducing the amount of phosphate in the body. [1] Sevelamer carbonate. Sevelamer is an insoluble polymeric amine, which is protonated once in the intestines and this allows it to bind dietary phosphate.
Once calcium is confirmed to be elevated, a detailed history taken from the subject, including review of medications, any vitamin supplementations, herbal preparations, and previous calcium values. Chronic elevation of calcium with absent or mild symptoms often points to primary hyperparathyroidism or Familial hypocalciuric hypercalcemia. For ...
Calcium levels initially tend to be low, but as the situation improves calcium is released from where it has precipitated with phosphate, and vitamin D production resumes, leading to hypercalcemia (abnormally high calcium levels). This "overshoot" occurs in 20–30% of those people who have developed kidney failure.
Malabsorption – This includes gastrointestinal damage, and also failure to absorb phosphate due to lack of vitamin D, or chronic use of phosphate binders such as sucralfate, aluminum-containing antacids, and (more rarely) calcium-containing antacids. [citation needed] Intravenous iron (usually for anemia) may cause hypophosphatemia.