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Specializes in O/G ,emergency,internal medicidialysis.

Hi dear all:

can kindly explain my one question? one of my pt biochemistry result po4 4.9 mmol then calcium9mg/dl ,IPTH 66pm/l ,she is on ca .cacitate 1-1-1 tabs tds, then doctor change to 2-3-2 tabs tds ...

thans!

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Specializes in Medical.

The patient is hypocalcaemic (normal Ca++ range is 2.23 - 2.50mmol/L or 40.14 - 45mg/dL), very hyperphosphatemic (normal PO4 is 0.6 - 1.30mmol/L), and has borderline hyperparthyroidism. Although patient with end-stage renal disease - which I assume your patient has - won't have normal values even if optimally managed, but at least this gives you a range to work from.

We don't use calcium calcitate here, so I don't know if that's a calcium supplement or a phosphate binder or both. In either case your patient needs increased calcium and increased phosphate absorption.

Assuming calcium calcitate is a calcium supplement, increasing the mealtime dose will increase phosphate absorption from the gut, lowering serum phosphate levels.

Where I work we usually also give calcium supplementation between meals, when it won't be bound will phosphate and can therefore be used to increase serum calcium levels.

I hope this helps and isn't too confusing.

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Specializes in O/G ,emergency,internal medicidialysis.

Thank you so much ,:heartbeattalaxandra.

sorry for spelling wrong ,is calcium acitate,phosphate binder.

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Specializes in Medical.

You're welcome :)

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