Calcium, Phosphate and Magnesium Disorders

Abstract

Calcium, phosphate and magnesium are essential for human function and life. Each electrolyte is readily found in the human diet, and homeostasis is tightly regulated by the intestine, kidney and bone as well as other critical hormones, receptors and transporters. Disturbance to this balance can result in symptomatic disease and life-threatening manifestations. Calcium and phosphate are particularly co-dependent with disruption to the balance of one often influencing the other. It is important that clinicians have a thorough understanding of the mechanisms underplaying the homeostasis of each electrolyte as they have implications for prevention and management of disease. This chapter aims to outline the importance of calcium, phosphate and magnesium; the regulation of each electrolyte and the consequences of imbalance.

Correlation of Serum Fibroblast Growth Factor 23 With Left Ventricular Diastolic Function in Chronic Kidney Patients

“…14 The main organ target of FGF23 is the renal. Fibroblast Growth Factor 23 inhibits phosphate reabsorption by suppresses sodium phosphate cotransporter 2a and 2c in proximal tubules (Heron, 2018), (Shimada et al, 2004), (Kdigo, 2012). High level of FGF23 in chronic kidney disease is stimulated by persistent hyperphosphatemia, resulting in high plasma FGF23 concentrations and lead to target organ damage, including cardiovascular system (Scialla & Wolf, 2014).…”

“…The change in phosphate metabolism is a consequences of CKD. Along with the decreased of LFG, there's a raise in urine fractional excretion of phosphate as a compensation to maintain normal phosphate serum level (Heron, 2018).…”

Relationships among Macro-Minerals, Other Selected Serum Markers of Bone Profile and Milk Components of Dairy Cows During Late Lactation

“…Osteogenesis is controlled by local factors such as: growth factors, cytokines and prostaglandins produced by bone cells as well as by systemic factors important for maintaining bone homeostasis such as parathyroid hormone (PTH), calcitonin, 1,25dihydroxyvitamin D3, glucocorticoids, androgens and estrogens (Manolagas 2000, Phan et al, 2004. However, PTH stimulators are also macro-minerals: reduced serum Ca and Mg or increased serum P, whereas PTH inhibitors may be the elevated serum calcium levels, or significantly reduced serum magnesium concentrations (Heron 2018). In addition, osteoblasts synthesize collagenous proteins, non-collagenous proteins and glycosylated proteins, including alkaline phosphatase (ALP), and secrete them into the extracellular matrix (Clarke 2008).…”

“…Moreover, in the case of serum magnesium, 55% remains unbound, 30% is bound with proteins such as albumin, 15% is bound to anions such as phosphate and citrate, while in the case of serum phosphate, approximately 55% is free, 35% is bound with small cations, and 10% is protein bound (Risteli et al, 2012, Heron 2018.…”