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Disorders of Calcium and Magnesium Metabolism

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Pediatric Kidney Disease

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Abstract

Human calcium and magnesium homeostasis critically depends on the renal conservation or excretion. Changes in renal calcium and magnesium handling may either reflect a renal compensation for disturbances in body homeostasis or a primary defect in renal tubular transport. Calcium homeostasis is controlled by a complex interplay of different endocrine systems including the parathyroid gland and vitamin D and is tightly linked to phosphate metabolism. Alterations may result in calcium deficiency as well as calcium excess. Irrespective of the underlying etiology, hypercalciuria represents a major risk factor for renal calcifications and kidney stone disease. Inherited disorders of calcium metabolism may affect endocrine control as well as renal tubular transport processes.

In contrast, disturbances in human magnesium homeostasis predominantly occur in the form of magnesium deficiency either by reduced nutritional intake, intestinal malabsorption or renal loss. Hypermagnesemia is a rare phenomenon and usually reflects a reduction in glomerular filtration rate. Next to acquired disorders and side effects of therapeutic agents, inherited disorders associated with renal magnesium wasting affect a significant subset of patients, especially in infancy and childhood.

In the past decades, molecular studies have substantiated the role of a variety of genes and their encoded proteins in human epithelial calcium and magnesium transport. In many cases, careful clinical and biochemical assessment allows to distinguish the different disease entities. Here, we summarize the current state of knowledge on the pathophysiology, clinical spectrum, diagnostics, and therapy of acquired and hereditary disorders of renal calcium and magnesium handling.

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  1. Department of General Pediatrics, Pediatric Nephrology, University Hospital Münster, Münster, Germany

    Karl Peter Schlingmann & Martin Konrad

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    Franz Schaefer

  2. Emory School of Medicine, Emory University, Atlanta, GA, USA

    Larry A. Greenbaum

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Schlingmann, K.P., Konrad, M. (2023). Disorders of Calcium and Magnesium Metabolism. In: Schaefer, F., Greenbaum, L.A. (eds) Pediatric Kidney Disease. Springer, Cham. https://doi.org/10.1007/978-3-031-11665-0_37

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