Hypocalcemia after acute phosphate load is secondary to
reduced calcium efflux from bone: Studies in patients with minimal
renal function and varying parathyroid activity.
J Am Soc Nephrol
(Aug) 6:273-280 1995
The mechanism of hypocalcemia after phosphate loading in ESRD is
unknown. In 13 functionally-anephric pts with ESRD, infusion of P (0.4
mmol/kg over 4 h) resulted in an equivalent fall in serum total and ionized
calcium, suggesting little role for ECF Ca-P precipitation (note: in support
of Adler et al. KI 28:932-5, 1985). Net flux of Ca from ECF to bone (45-Ca
disappearance rate) was unchanged. These data suggest that with
phosphate loading there
was a reduced movement of calcium from bone to ECF.
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