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Calcium metabolism and its disorders: hypercalcemia and hypocalcemia

Czech version

Authors: Tenčíková Alexandra
Authors‘ workplace: III. Interní klinika – nefrologická, revmatologická a endokrinologická, LF UP a FN Olomouc
Published in: Clinical Osteology 2023; 28(4): 125-132
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Overview

Calcium (Ca2+) is one of the most important ions in the body. It plays numerous body functions such as skeletal mineralization, blood coagulation, nerve conduction, muscle contraction, transmission of intracellular processes and enzyme activation. In human body, it occurs mainly extracellularly, and its greatest amount (about 99 %) is in the bones and teeth in the form of hydroxyapatite. Serum calcium exists in free form (ionized), bound to proteins (mainly albumin) and bound to complexes. The level of total serum calcium is therefore dependent on the level of serum albumin. When its level is abnormal, ionized calcium or calcium corrected for albumin is preferred. The hormonal regulation is mediated by parathyroid hormone (PTH) and calcitriol. Calcitonin plays a minor role in calcium metabolism, protects the body from sudden increases of calcium levels, and becomes more important during pregnancy and lactation. Calcium metabolism is closely linked to the phosphate and magnesium metabolism and is dependent on intestinal absorption, bone remodeling and renal reabsorption. Disorders of calcium metabolism are caused by disorders of regulatory mechanisms. This review summarizes knowledge about calcium metabolism and focuses on conditions leading to hypercalcemia and hypocalcemia.

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