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calcium metabolism

Re-Evaluating the Ca x P Product

Heard an excellent presentation at our Renal Grand Rounds today by Dr. Charles O’Neill of Emory University, regarding the process of pathologic calcification in CKD/ESRD patients. One of the points I took away from this talk is that…

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Renal TB

TB is classically thought of as a pulmonary disease–and in general, this is true, as pulmonary TB is by far the most common (and often very severe) manifestation of infection by Mycobacterium tuberculosis. However, the most common NON-pulmonary…

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Sensipar for APKD?

Following on the heels of studies showing a potentially beneficial effect for vasopressin receptor antagonists and rapamycin in the treatment of renal cystic disorders, an article in this month’s JASN by Gattone et al suggests another class of…

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Betel Nut Chewing

Following up on the discussion of milk-alkali syndrome, a similar syndrome (hypercalcemia, metabolic alkalosis, and acute renal failure) may also occur due to betel nut chewing. Betel nut chewing is a common habit and cultural practice amongst Indian…

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History of the Milk-Alkali Syndrome

Heard about a case of milk-alkali syndrome at Renal Grand Rounds yesterday. This is an interesting condition whose pathophysiologic mechanism really tests your knowledge of calcium and acid-base homeostasis. I won’t attempt to chart the pathway but a…

Lithium-Induced Hyperparathyroidism

Lithium, a very effective medication in the treatment of bipolar disorder, has a variety of well-documented renal side effects, including interstitial nephritis and nephrogenic diabetes insipidus.  A less well-recognized complication is an increased prevalence of hyperparathyroidism in chronic…

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Hypoparathyroidism

One logical way to classify the different etiologies of hypocalcemia is to break them down into LOW PTH STATES and HIGH PTH STATES. Today I’ll review the HYPOCALCEMIA WITH LOW PH STATES, or in other words, the causes…

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Symptoms and Signs of Hypocalcemia

Calcium is a critical ion for a number of cellular signaling events. As such, it is not surprising that hypocalcemia leads to a wide variety of signs and symptoms. The dominant presentation of hypocalcemia is usually neurologic in…

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