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Insufficient vitamin D synthesis such as defective 25-hydroxylation, 1-alpha hydroxylase, and 1-alpha 25-hydroxylation can also contribute to vitamin D deficiency. Lack of vitamin D leads to reduced calcium absorption by the intestine leading to hypocalcemia and increased parathyroid hormone secretion. This increases bone resorption.
If the underlying cause of the hypocalcemia can be addressed, the hyperparathyroidism will resolve. In people with chronic kidney failure, treatment consists of dietary restriction of phosphorus; supplements containing an active form of vitamin D, such as calcitriol, doxercalciferol, paricalcitol; and phosphate binders, which are either calcium-based and non-calcium based.
Vitamin D related hypocalcemia may be associated with a lack of vitamin D in the diet, a lack of sufficient UV exposure, or disturbances in renal function. Low vitamin D in the body can lead to a lack of calcium absorption and secondary hyperparathyroidism (hypocalcemia and raised parathyroid hormone). [1]
Vitamin D activation occurs in the kidney. PTH up-regulates 25-hydroxyvitamin D 3 1-alpha-hydroxylase, the enzyme responsible for 1-alpha hydroxylation of 25-hydroxy vitamin D, converting vitamin D to its active form (1,25-dihydroxy vitamin D). This activated form of vitamin D increases the absorption of calcium (as Ca 2+ ions) by the intestine ...
[4] [8] Laboratory investigations include evaluating blood calcium and alkaline phosphatase, which are always increased in tertiary hyperparathyroidism. Other common results from laboratory investigations would include decreased vitamin D levels, elevated blood parathyroid hormone and hyperphosphatemia. [9] [8] [1] [4]
Vitamin D and calcium are essential ... some questions about whether high doses might be beneficial of vitamin D and calcium,” Rao said. ... to adults with severe vitamin D deficiency, low bone ...
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