Core Messages: Intracellular calcium concentrations are very low compared to blood concentrations. Treatment of calcium disorders requires an understanding of the distribution of calcium in the body fluids, primarily the extracellular fluid. The skeletal system acts as a reservoir for calcium and can buffer many changes in the blood calcium concentration. Long term regulation of serum calcium involves the coordinated function of several organs. While hypocalcemia is common in the intensive care setting, aggressive treatment is not always indicated. Phosphate regulation is primarily achieved by the kidneys. Treatment of severe hyperphosphatemia usually requires renal replacement therapy.
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