- Diphosphonate will suppresses hypercalcaemia in
hyperpara- thyroidism
4- Dialysis in renal failure especially on using low Ca2+ dialysate
will be very effective in decreasing serum calcium.
Hypocalcaemia
It is plasma calcium concentration less than 2.20 mmol/litre (8.5
mg/dl).
Causes of hypocalcaemia
1- Renal failure
2- Hypoparathyroidism
(surgical, idiopathic, pseudohypoparathyroidism)
3- Vitamin D deficiency
4- Hypoalbuminaemia
5- Acute pancreatitis
In renal failure, hypocalcaemia is due to the lack of activation of
vitamin D and to the hyperphosphataemia which will cause drop of serum
calcium. The presence of acidosis will delay the manifestations of
hypocalcaemia by increasing serum ionised calcium.
Vitamin D deficiency may be due to decreased intake, decreased
exposure to sun light, defective gut absorption or lack of its activation.
Hypovitaminosis D is characterized with hypocalcaemia,
hypophosphataemia and hyperparathyroidism.
Clinical features of hypocalcaemia
1- Manifestations of the etiologic cause.