• Ca Calcium (2.2-2.5):
• PO4 - Phosphate (0.8-1.5 mmol/L**)**: Hyper-phosphatemia ↑PO4
• Calcitriol (1,25 VD) : inability to activate 1,25-OH
• Secondary (hypo Ca) hyperparathyroidism ↑

Kidney, bone health, Ca and PO3 homeostasis

Consequences:

• Osteitis fibrosa
• OP - Osteoporosis (demineralization)
• Fractures
• Bone Pain
• Pruritus (due to high PTH)

Management:

• Vitamin D Supplement → Calcitriol (1,25 VD) prescribed by nephrologist