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Bone 99%
25000mmol
Exchange Absorption
500mmol/24h 12mmol/24h
ECF
22,5mmol Plasma
9 mmol GUT
Formation
7,5mmol/24h
Secretion
Resorption
6mmol/24h
7,5mmol/24h
Reabsorption Glomerular
234mmol/24h Filtration
240mmol/24h
Faeces
19mmol/24h
Distribution
of calcium
Urine 6mmol/24h
BONE CALCIUM
Bone consists of osteoid, on which is deposited
inorganic hydrated calcium salts (hydroxyapatite).
(Ca10(PO4)6(OH)2)
Nondiffusible
Diffusible (bound to protein)
54% 46%
Ionized calcium
At birth 1.3-1.6 5.2-6.4
Neonate 1.2-1.5 4.8-5.9
Child 1.2-1.4 4.8-5.5
adult 1.2-1.3 4.6-5.3
Physiologic functions of calcium
ions
hypercalcemia – + hypocalcaemia
PTH SECRETION
Bone kidney
Promotes:
Stimulate:
Ca² absorption
Osteoclastic activity
HPO4 excretion
(release Ca²,HPO4)
1-α-hydrolase activation
Calcium homeostasis
Calictriol: Circulating 25-OH vit D
(INACTIVE)
1-α- hydroxylase +
1,25(OH)2 vit D
intestine Kidney
Mg normal Mg low:
Mg high:
Parathyroid gland PTH release is inhibited
are suppressed
Measure serum PTH
Plasma phosphate
12mg/dl
Inorganic
(phosphorus) Organic
25% 75%
1. Colorimetric method:
Determinations are usually made only of inorganic
phosphorus after removing the protein by
precipitation with trichloroacetic acid (TCA).
Serum Ca²
Low or
normal increased
Diuretics; hyperparathyroidism
Renal tubular defects;
Recovery from burns;
Inadequate vit D.
High serum PO4
Increased Normal
(>1500mg/day) (<1500mg/day)