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Chapter-33 Calcium Metabolic Emergencies

BOOK TITLE: Principles of Pediatric & Neonatal Emergencies

Author
1. Virmani Anju
2. Prajapati BS
ISBN
9788184489507
DOI
10.5005/jp/books/11182_33
Edition
3/e
Publishing Year
2011
Pages
4
Author Affiliations
1. Indraprastha Apollo/MAX/Sunder Lal Jain Hospitals, New Delhi, India, Sunderlal/ Maan/ Max/ Apollo Hospitals, C 6/ 6477 Vasant Kunj, New Delhi, e-mail: a4@vsnl.com, Indraprastha Apollo, Max, Pentamed and Sunderlal Jain Hospitals, Delhi, Apollo and Max Hospitals, New Delhi, India, Apollo, Max, Pentamed and Sunderlal Jain Hospitals, New Delhi, India, Apollo, Max, Pentamed and Sundar Lal Jain Hospital, New Delhi, India, Indraprastha Apollo Hospital, New Delhi, C6/ 6477, Vasant Kunj, New Delhi 110070, Pentamed and Rainbow Hospitals; Max Hospitals (Saket, Gurugram) New Delhi, India, Max Smart Superspecialty Hospital, Saket, New Delhi, Pentamed Hospital and Rainbow Hospital, New Delhi and Max Hospital, Gurugram, Haryana, India, Max Smart Saket, Pentamed and Rainbow Hospitals, New Delhi, India, Max, Pentamed, and Sunderlal Jain Hospitals, New Delhi, India, Max, Pentamed, and Apollo Hospitals, New Delhi, India, MAX SMART and MAX Gurugram, RAINBOW; PENTAMED Hospitals, New Delhi
2. Sheth LG General Hospital, Smt. NHL Municipal Medical College, Ahmedabad, Gujarat, India
Chapter keywords

Abstract

Calcium plays an integral role in membrane electrical conduction, muscle contraction, enzyme activity and skeletal mineralization. Calcium exists in three fractions: ionized or free calcium, accounting for about 50 percent of total calcium; protein bound calcium, accounting for 40 percent; and calcium complexed with phosphate, citrate or bicarbonate, accounting for the remaining 10 percent. Ionized calcium is the physiologically active portion which is tightly regulated. Therefore serum calcium level estimation should also include the ionized calcium level. Calcium homeostasis is maintained by vitamin D and parathyroid hormone (PTH). Hypocalcemia causes an increase in PTH secretion, which through several different actions, restores serum calcium to normal. PTH increases calcium retention by promoting renal reabsorption of calcium, blocking renal reabsorption of phosphate, and increasing the activation of 25(OH)D to the bioactive 1,25(OH)2D, i.e. calcitriol.

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