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Normal Regulation of Serum Calcium

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Hypercalcemia

Part of the book series: Contemporary Endocrinology ((COE))

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Abstract

Serum calcium is tightly regulated within the normal range due to its importance in many physiological processes. The major regulatory hormones responsible for maintaining “eucalcemia” are parathyroid hormone (PTH) and vitamin D. PTH has direct and indirect actions on three key organs responsible for the regulation of calcium: the skeleton, kidney, and gastrointestinal tract. In the skeleton, PTH increases bone resorption and acts indirectly to effect the dissolution of calcium salts. In the kidney, PTH acts to increase calcium reabsorption and increase 1-alpha hydroxylase activity to enhance activation of vitamin D, which secondarily increases calcium absorption in the gastrointestinal tract. The concerted actions of these hormones and organs facilitate the maintenance of normal serum calcium. This chapter will review the normal regulation of serum calcium and phosphate, which is closely linked to the regulation of calcium.

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Abbreviations

1,25-OH VitD3:

1,25-dihydroxycholecalciferol

25-OH VitD3:

25-hydroxycholecalciferol

CaSR:

calcium sensing receptor

CYP:

cytochrome p450

dL:

deciliter

eGFR:

estimated glomerular filtration rate

FGF23:

fibroblast growth factor 23

FGFR:

fibroblast growth factor receptor

iPTH:

intact PTH

kDa:

kilodaltons

L:

liter

meq:

milliequivalent

mg:

milligram

NaPi:

sodium phosphate cotransport

NCX:

sodium calcium exchanger

NKCC2:

sodium potassium 2 chloride channel

PiT-2:

inorganic phosphate transporter

PMCA1b:

plasma membrane calcium ATPase

PTH:

parathyroid hormone

PTHrP:

parathyroid related protein

RXR:

retinoic X receptor

TRPV:

transient receptor potential family, vanilloid subgroup

VDR:

vitamin D receptor

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Authors and Affiliations

  1. Renal, Electrolyte and Hypertension Division, University of Pennsylvania, Philadelphia, PA, USA

    Ryan Spiardi & Abdallah S. Geara

Authors
  1. Ryan Spiardi
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  2. Abdallah S. Geara
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Correspondence to Abdallah S. Geara .

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Editors and Affiliations

  1. Division of Endocrinology, Columbia University Irving Medical Center, New York, NY, USA

    Marcella Donovan Walker

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Spiardi, R., Geara, A.S. (2022). Normal Regulation of Serum Calcium. In: Walker, M.D. (eds) Hypercalcemia. Contemporary Endocrinology. Humana, Cham. https://doi.org/10.1007/978-3-030-93182-7_1

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  • DOI: https://doi.org/10.1007/978-3-030-93182-7_1

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  • Publisher Name: Humana, Cham

  • Print ISBN: 978-3-030-93181-0

  • Online ISBN: 978-3-030-93182-7

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