What are the manifestations of calcium and phosphorus metabolism disorders in patients with chronic kidney disease?

In general, patients with chronic kidney disease (CKD) may exhibit various manifestations of calcium and phosphorus metabolism disorders, including abnormalities in kidney function, bones, muscles, the gastrointestinal tract, and the respiratory system. If any of these conditions are present, it is recommended to consult a physician for evaluation. The specific analysis is as follows:

1. Renal Function Abnormalities

The essence of chronic kidney disease is progressive impairment of kidney function, leading to a decreased glomerular filtration rate. This affects phosphorus excretion, activation of vitamin D, and normal regulation of bone metabolism, thereby triggering disturbances in calcium and phosphorus metabolism.

2. Bone Abnormalities

In patients with chronic kidney disease, declining kidney function reduces the ability to excrete phosphorus and impairs vitamin D activation. This may lead to hyperphosphatemia and hypocalcemia, subsequently causing bone abnormalities. Hyperphosphatemia can overstimulate the parathyroid glands to secrete excessive parathyroid hormone, increasing the risk of osteoporosis and fractures, ultimately resulting in renal osteodystrophy.

3. Muscle Abnormalities

Hypocalcemia is a common issue in chronic kidney disease. Due to the kidneys' inability to adequately activate vitamin D, calcium absorption is impaired. Hypocalcemia increases neuromuscular excitability, manifesting as muscle spasms, cramps, and other muscular abnormalities.

4. Gastrointestinal Abnormalities

In patients with chronic kidney disease, increased intestinal absorption of phosphorus leads to elevated serum phosphorus levels, potentially causing hyperphosphatemia. This may negatively affect the gastrointestinal system, particularly when consuming a high-phosphorus diet, which could exacerbate calcium and phosphorus metabolism imbalances.

5. Respiratory System Abnormalities

Hyperphosphatemia and hypocalcemia caused by chronic kidney disease may impact the respiratory system. Muscle abnormalities and increased nerve excitability may impair the function of respiratory muscles, thereby affecting the breathing process.

Patients with chronic kidney disease should maintain a light, nutritionally balanced diet in daily life to support recovery.