Kalzium ist elementar für zahlreiche Stoffwechselprozesse und wird hormonell gesteuert.
Diese hormonellen Mechanismen sind erstaunlich effektiv, die Kalziumwerte sehr zuverlässig
in einem engen Bereich zu regulieren – dennoch verursachen Abweichungen der Serumkalziumwerte
recht häufig klinische Probleme, deren Ursachen, Diagnostik und Therapie in diesem
Dossier weiter erörtert werden sollen.
Abstract
Calcium is essential for numerous metabolic processes and is hormonally controlled.
These hormonal mechanisms are surprisingly effective in regulating calcium levels
very reliably within a narrow range – but deviations in serum calcium levels quite
often cause clinical problems. Hypercalcemia predominantly occurs in primary hyperparathyroidism
or is associated with tumors (especially osteolytic processes). Hypocalcemia is usually
due to hypoparathyroidism (75% surgical, 25% primary) or vitamin D deficiency. Causal
calcium management requires identification of the etiology of the disorder. Symptomatic
therapy depends on the severity of the electrolyte imbalance. Calcium is lowered in
hypercalcemia via forced diuresis, the administration of calcitonin and bisphosphonates
or denosumab, if necessary, via dialysis. Severe hypocalcemia is corrected acutely
with parenteral calcium administration and any further treatment decisions and prognosis
depend on the underlying disease.
Schlüsselwörter
Hyperkalzämie - Hypokalzämie - Serumkalzium - hyperkalzämische Krise - Diagnose -
Therapie
Keywords
Hypercalcemia - Hypocalcemia - Serum calcium - hypercalcemic crisis - diagnosis -
therapy
