Figure 112

Hypercalcemia leads to renal vasoconstriction and a reduction in the glomerular filtration rate. However, no expression of the calcium-sensing receptor has been reported so far in renal vascular or glomerular tissue. Calcium receptor expression is present in the proximal convoluted tubule, on the basolateral side of cells of the distal convoluted tubule, and on the basolateral side of macula densa cells. Functional correlates of calcium receptor expression at these sites are not yet clear [3].

Hypercalciuria leads to microscopic hematuria and, in fact, is the most common cause of microscopic hematuria in children. The mechanism is presumed to involve microcrystallization of calcium salts in the tubular lumen. Conflicting effects of calcium on urinary acidification have been reported in clinical settings in which other factors, such as parathyroid hormone levels, may explain the observations. whether or not it is the result of renal tubular acidosis, Nephrocalcinosis often is associated with impaired urinary acidification, whether or not it is the result of renal tubular acidosis.

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