Figure 1822

Hypocalcemia and the vitamin D-parathyroid hormone (PTH) axis in acute renal failure (ARF). ARF is also frequently associated with hypocalcemia secondary to hypoalbuminemia, elevated serum phosphate, plus skeletal resistance to calcemic effect of PTH and impairment of vitamin-D activation. Plasma concentration of PTH is increased. Plasma concentrations of vitamin D metabolites, 25-OH vitamin D3 and 1,25-(OH)2 vitamin D3, are decreased [44]. In ARF caused by rhabdomyolysis rebound hypercalcemia may develop during the diuretic phase. (Adapted from Druml et al. [44]; with permission.)

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