Evaluation and Treatment of Pediatric Calcium Disorders

Purpose of review: In this review we revisit normal calcium physiology and define hypo- and hypercalcemia in children. We also provide a physiology-based approach for diagnosis of pediatric calcium disorders with treatment recommendations. Recent findings: Our understanding of genetics and the intricacies of human physiology continues to improve as does our ability to identify causative mutations and uncover the mechanisms underlying disorders of calcium. Calcium homeostasis remains integral to many processes throughout the body and is maintained by a complex interplay of the gut, bone, and kidney. Discovery of the calcium sensing receptor and its control of parathyroid hormone secretion has further enriched our understanding, and recent studies have further elucidated regulation of renal calcium handling. Summary: Hyper- and hypocalcemia remain physiologically important electrolyte derangement with short- and long-term sequela for children. Correct diagnosis of the underlying etiology of these disorders remains central to proper treatment. Newer drugs have enhanced our ability to treat these disorders, most specifically hypercalcemia.