Algoritma Hipokalsemia

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HYPOCALCEMIA ALGORITHM

Low Calcium level

Low Vitamin D deficiency

Phosphat

High Hypoparathyroidsm or Pseudohypoparathyroidism

Low or normal True hypoparathyroidism

Parathyroid Hormone

High

Calcium Low, Creatinine high  Renal Failure

Calcium:Creatinine ratio (urine) Normal to High Ratio  renal tubules


unresponsive to PTH

 Pseudohypoparathyroidism

25-Hydroxy vit.D Low  Vit.D deficiency


 Increase hepatic clearance
(anticonvulsant use)

Defective conversion from


Low
25-hydroxyvitamin D
1,25 Dihydroxy vit.D

High Defect Vit.D receptor

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