ARMYMED @ARMYMED
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#1,25-(OH)-D
Ca-+
Nat
ER
Na
Cytoplasmic receptor
Nuclear receptor
DNA
mRNA
#Lipid synthesis
Golgi body
Protein synthesis
Membrane lipids
CaBP
#ATPase
#Ca-+
Blood
#ATPase #Basal membrane
#Mitochondrion
Vesicle?
#Cytoplasmic #CaBP
(Ca-binding protein)
Brush border
Ca?+
#1,25-(OH)-D Ca
Light,
UVB, heat
Cholecalciferol vitamin D3
DBP
DBP
Vitamin D
Pool
Liver
7-Dehydro-cholesterol
DBP
→ 25-(OH)D
1 Hydroxyl-apatite
Bone
Fat, bile acids
Chylomicrons
Vitamin D from food
Skin
#Parathyroid
#PTH
secretion
Circulating
25-(OH)D
DBP
Kidney
• 25-(OH)D
1,25-(OH,) D
1,25-(OH)w D
† Ca?+-retention
Metabolite
#Bile
Dehydro-cholesterol DBP → 25-(OH ... Circulating 25-(OH ... • 25-(OH)D 1,25 ... -(OH,) D 1,25-( ... OH)w D † Ca?
High plasma phosphate level
Plasma Ca?+ level drops
Kidneys
Reduction of
25-(OH) D hydroxy-lase activity
Increased PTH secretion
Parathyroid
Increased phosphate exeretion
Skeleton
Reduced phosphate
Reduction of 25-(OH ... ) D hydroxy-lase
#ICUCard
RENAL
GFR
90-131
mL/min
((140-age)*Wt)/(72*Cr)
Glomerular Filtration Rate (Cockcroft)
CI Cr
90-131
mL/min
(CrU * volume)/CrS
Creatinine Clearance
FENa
0.0-1.0
%
((U/P Na)/(U/P Cr))*100
Fractional Excretion of Na+
Na req
mEq
(125-Na)*0.6*Wt
Required Sodium
FE Urea
Na req mEq (125 ... (m=measured. d= ... 1200-2500 kcal/d
#Estrogen
25-OH-D3
formation
#HDL
#LDL
#VLDL Y
Proliferation and desquamation of #vaginalepithelium
In children: delayed epiphyseal fusion
#Osteoporosis
Atherosclerosis
Vaginal infections
Tall stature
#Progestogen
#mammarygland tubes
No buildup of uterus
#Estrogen 25-OH-D3