Diabetes Care | Care of People with Metabolic Problems: Endocrine and Metabolic | Calcium and Bone Metabolism Disorders in Primary Care

Calcium and Bone Metabolism Disorders in Primary Care
Session Overview
Description
This session looks at the common presentations of calcium and bone metabolic disorders and outlines a rational approach to their investigation.

This session was reviewed by Khyati Bakhai and last updated in February 2020.

Learning Objectives
By the end of this session you will be able to:

• List the common and important causes of hypercalcaemia
• Describe a systematic approach to the investigation of hypercalcaemia in primary care
• Describe how common bone metabolism disorders present in primary care
• Describe the investigation and management of common bone metabolism disorders
• Recognise the clinical features of vitamin D deficiency

Calcium is the most abundant mineral in the body; 99% of the body’s calcium is found in the skeleton.

In plasma, calcium exists as a protein-bound fraction which is complexed with phosphate and citrate as ionised calcium, the biologically active fraction.

Ionized calcium is regulated tightly by parathyroid hormone and 1,25-dihydroxycholecalciferol (calcitriol). Calcium is exchanged between extracellular fluid, bone, gut and kidney - the major changes of which are regulated by parathyroid hormone, vitamin D and calcitonin. These are important for neuromuscular control, bone metabolism and blood coagulation.