Skip to main content

Calcium-Phosphate Product and Its Significance In CKD

Chronic kidney disease, in its later stages, may cause hyperphosphatemia. Hyperphosphatemia promotes the bone resorption and tend to increase the amount of calcium in vessels and increases the risk of vascular calcification. Parathyroid hormone also increases in chronic kidney disease which also promotes bone resorption, hypercalcemia, and vascular calcification. Vitamin D 3, if given in a patient who has hyperphosphatemia, may actually promote bone resorption and vascular calcification if PTH is more than 100. So if there is hyperphosphatemia, vitamin D should be given along with a phosphate binder such as sevelamer if the calcium-phosphate product is more than 55.

If Calcium phosphate product is more than 55, it means you shouldn't give calcium-based phosphate binders such as calcium acetate, instead start the patient on Sevelamer. But if Calcium phosphate product is less than 55 then give patient calcium acetate as a phosphate binder. Decide the dose of vitamin D based on PTH level. If it is more than 100 give an activated form of vitamin D which is 1-25 dihydroxy vitamin D3.

For example, if a patient has corrected calcium (How to calculate corrected calcium for hypoalbuminemia?) of 10.5 and phosphate of 5.5, then his calcium phosphate product will be (10.5 x 5.5) 57.75. So we will start the give sevelamer to the patient as a phosphate binder.

Summary: 

If Calcium phosphate product is > 55 give Sevelamer as a phosphate binder. 
If Calcium phosphate product is < 55 give Calcium acetate as a phosphate binder. 
If PTH is more than 100 give an activated form of vitamin D. 


Comments

Popular posts from this blog

Human Parasites, Types of Parasites, and Classification

Parasite: A parasite is a living organism which gets nutrition and protection from another organism where it lives. Parasites enter into the human body through mouth, skin and genitalia. In this article, we will generally discuss the types and classification of parasites. It is important from an academic point of view. Those parasites are harmful, which derives their nutrition and other benefits from the host and host get nothing in return but suffers from some injury. Types of Parasites Ecto-parasite: An ectoparasite lives outside on the surface of the body of the host. Endo-parasite: An endo-parasite lives inside the body of the host, it lives in the blood, tissues, body cavities, digestive tract or other organs. Temporary parasite: A temporary parasite visits its host for a short period of time. Permanent parasite: Permanent parasite lives its whole life in the host. Facultative parasite: A facultative parasite can live both independently and dependently. It lives in the...

IELTS or OET - Reviews - Personal Experience - Which to Choose - IETLS vs OET

OET and IELTS both are used to assess the knowledge of English Language. The basic difference between the above two is this, IETLS is a more generalized English language assessment test, on the other hand, OET is profession specific. For example, if you are a doctor, the content of the test will be related to your occupation. Because of this, the OET is being chosen by many healthcare professional instead of IELTS. Both tests have the same sub-categories, that is listening, speaking, writing and reading. Lets us discuss the differences one by one. TEST OET IELTS OET Compared to IELTS is ………. (Author’s opinion) Speaking You will need to do two role plays. You will be given a situation and asked to counsel the patient about a disease and treatment or break the bad news. It has 3 parts, first is an introduction and general question, In the second part you will be provided with a topic to speak for 2 minutes. In the 3rd part, you will b...