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Targeting serum calcium in chronic kidney disease and end-stage renal disease: is normal too high?

W Charles O'Neill1

  • 1Renal Division, Emory University School of Medicine, Atlanta, Georgia, USA.

Kidney International
|January 14, 2016
PubMed

Insights

Correcting low calcium in advanced chronic kidney disease (CKD) and end-stage renal disease (ESRD) may cause harm. Lowering calcium targets might offer benefits with minimal risks and warrants further investigation.

Area of Science:

  • Nephrology
  • Mineral and Bone Disorders

Background:

  • Hypocalcemia is prevalent in advanced chronic kidney disease (CKD) and end-stage renal disease (ESRD).
  • Current practice aims to normalize serum calcium levels, potentially preventing symptoms and managing hyperparathyroidism.

Purpose of the Study:

  • To evaluate the established practice of normalizing serum calcium in CKD/ESRD.
  • To explore the potential benefits and risks of targeting lower serum calcium levels.

Main Methods:

  • Review of existing literature and recent data regarding calcium management in CKD/ESRD.
  • Analysis of potential adverse effects of normalized calcium, including vascular calcification and adynamic bone disease.

Main Results:

  • Limited evidence supports normalizing calcium levels.
  • Data suggest that normalization may promote vascular calcification and adynamic bone disease.

Conclusions:

  • The benefits of normalizing serum calcium in CKD/ESRD are not well-established.
  • Targeting lower calcium levels may present minimal risks and significant potential benefits, meriting further research.

Keywords:
calciumchronic kidney diseasevascular calcification

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