1130
UNIT X
Disorders of Renal Function and Fluids and Electrolytes
2. A 35-year-old, 70-kg white man with diabe-
tes mellitus is seen in the diabetic clinic for
his 6-month check-up. His serum creatinine,
which was slightly elevated at his last visit, is
now 1.6 mg/dL. Use the following Web site
to estimate his GFR:
/
creatinine-clearance-cockcroft-gault-equation
A. Would he be classified as having CKD? If so,
what stage? What might be done to delay or
prevent further deterioration of his kidney
function?
3. CKD is accompanied by hyperphosphatemia,
hypocalcemia, impaired activation of vitamin D,
hyperparathyroidism, and skeletal complications.
A. Explain the impaired activation of vitamin D
and its consequences on calcium and phos-
phate homeostasis, parathyroid function, and
mineralization of bone in persons with CKD.
B. Explain the possible complications of the
administration of activated forms of vitamin
D on parathyroid function and calcium and
phosphate homeostasis (e.g., calcium × phos-
phate product).
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