Cited by 888Parathyroid Disorders and TreatmentsBone health and osteoporosis researchVitamin D Research Studies

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Calcium Metabolism in Health and Disease

Peacock, Munro·2010·Clinical Journal of the American Society of Nephrology

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Abstract

This brief review focuses on calcium balance and homeostasis and their relationship to dietary calcium intake and calcium supplementation in healthy subjects and patients with chronic kidney disease and mineral bone disorders (CKD-MBD). Calcium balance refers to the state of the calcium body stores, primarily in bone, which are largely a function of dietary intake, intestinal absorption, renal excretion, and bone remodeling. Bone calcium balance can be positive, neutral, or negative, depending on a number of factors, including growth, aging, and acquired or inherited disorders. Calcium homeostasis refers to the hormonal regulation of serum ionized calcium by parathyroid hormone, 1,25-dihydroxyvitamin D, and serum ionized calcium itself, which together regulate calcium transport at the gut, kidney, and bone. Hypercalcemia and hypocalcemia indicate serious disruption of calcium homeostasis but do not reflect calcium balance on their own. Calcium balance studies have determined the dietary and supplemental calcium requirements needed to optimize bone mass in healthy subjects. However, similar studies are needed in CKD-MBD, which disrupts both calcium balance and homeostasis, because these data in healthy subjects may not be generalizable to this patient group. Importantly, increasing evidence suggests that calcium supplementation may enhance soft tissue calcification and cardiovascular disease in CKD-MBD. Further research is needed to elucidate the risks and mechanisms of soft tissue calcification with calcium supplementation in both healthy subjects and CKD-MBD patients.

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Authors: Peacock, M.
Affiliations: Indiana University School of Medicine (US)
Corresponding author: Peacock, Munro
ORCID: Peacock, Munro
Venue: Clinical Journal of the American Society of Nephrology
Publisher: Ovid Technologies (Wolters Kluwer Health)
Published: 2010-01
Volume: 5
Issue: Supplement_1
Pages: S23-S30
ISSN: 1555-9041 (ISSN-L)
DOI: 10.2215/cjn.05910809
OpenAlex: W2153942663
Cited by: 886
References: 53
Citations by year: 2026: 50 · 2025: 62 · 2024: 75 · 2023: 65 · 2022: 82 · 2021: 80 · 2020: 81 · 2019: 63 · 2018: 52 · 2017: 45 · 2016: 48 · 2015: 46 · 2014: 36 · 2013: 34 · 2012: 33
FWCI: 4.27
Type: journal article
Language: en
Open access: closed
Locations: Clinical Journal of the American Society of Nephrology (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Nephrology › Parathyroid Disorders and Treatments
Health Sciences › Medicine › Orthopedics and Sports Medicine › Bone health and osteoporosis research
Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Vitamin D Research Studies
Keywords: calcium metabolism, calcium balance, calcium homeostasis, calcium intake, calcium supplementation, chronic kidney disease-mineral and bone disorder, bone remodeling, parathyroid hormone, 1,25-dihydroxyvitamin D, hypercalcemia, hypocalcemia, calcinosis, cardiovascular disease, bone mass
MeSH terms: Animals, Bone and Bones, Calcium, Calcium, Dietary, Chronic Disease, Homeostasis, Humans, Hypercalcemia, Hypocalcemia, Intestinal Mucosa, Kidney, Kidney Diseases, Metabolic Diseases, Phosphates, Phosphorus, Vitamin D, Bone Remodeling, Hypophosphatemia, Nutrition Policy, Dietary Supplements, Hyperphosphatemia

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