Calcium and Phosphate Disorders: Core Curriculum 2024

Area of Science:

• Nephrology
• Endocrinology
• Mineral Metabolism

Background:

• Calcium and phosphate homeostasis is crucial for cellular, metabolic, and organ function.
• Parathyroid hormone (PTH), fibroblast growth factor 23 (FGF23), and 1,25-dihydroxyvitamin D are key hormonal regulators.
• These hormones act through complex feedback loops, receptors, ion channels, and transporters.

Purpose of the Study:

• To review the physiology and pathophysiology of calcium and phosphate disorders.
• To illustrate common and less common clinical scenarios encountered in nephrology practice.
• To enhance understanding of mineral metabolism for clinicians at all career stages.

Main Methods:

• Overview of hormonal stimuli and effects on calcium and phosphate balance.
• Presentation of a series of illustrative clinical cases.
• Discussion of pathophysiology through case examples.

Main Results:

• Cases cover a spectrum of clinical presentations in both outpatient and inpatient settings.
• Patient populations include those with normal kidney function, chronic kidney disease, kidney failure, and acute kidney injury.
• Disorders discussed include iatrogenic causes and native diseases, highlighting key pathophysiological mechanisms.

Conclusions:

• Understanding the interplay of PTH, FGF23, and vitamin D is essential for managing calcium and phosphate disorders.
• Case-based learning effectively demonstrates the complexities of mineral metabolism in diverse clinical contexts.
• This curriculum enhances essential knowledge for nephrology clinicians managing patients with these common and critical imbalances.