Complications
These can occur in any soft tissues, organs, or blood vessels, including the brain, kidneys, eyes, heart, and cardiac valves. Such calcifications are thought to contribute to renal dysfunction, hypertension, and renal stone formation. Calcifications in the basal ganglia and in other areas of the brain can be seen in patients with movement disorders or with no nervous system symptoms at all. The pathogenic role of these calcifications in functional alterations is not established.
Manifestation related to chronic hypoparathyroidism as a result of chronic hypocalcaemia and elevated serum phosphate levels.
If hypercalcaemia occurs, calcium and calcitriol, or calcium and vitamin D2/D3, should be stopped until serum calcium levels return to normal (often a few days). For calcitriol, this may take up to 1 week; for vitamin D2 or D3, the values may return to normal in weeks to months.
The long half-life of vitamin D2/D3 results in higher likelihood of vitamin D intoxication and hypercalcaemia. The shorter half-life of calcitriol reduces the risk of vitamin D intoxication and hypercalcaemia.
Reduced kidney function can occur as a result of chronic or intermittent hypercalcaemia, elevated calcium x phosphate product, elevated urinary calcium excretion, and even renal stones obstructing urinary flow.
Vitamin D and activated vitamin D analogues raise urinary calcium levels due to enhanced gut absorption of calcium and the lack of PTH action to stimulate calcium re-absorption in the distal tubule.
Use of this content is subject to our disclaimer