<details> <summary>What is the primary role of PTH?</summary> <p>PTH regulates calcium and phosphate metabolism, increasing blood calcium levels while decreasing phosphate levels.</p> </details> <details> <summary>How does PTH increase blood calcium levels?</summary> <p>PTH increases calcium levels by stimulating the conversion of vitamin D to calcitriol, enhancing calcium absorption from the kidney, and promoting calcium release from bones.</p> </details> <details> <summary>What is the effect of PTH on phosphate?</summary> <p>PTH reduces blood phosphate levels by decreasing renal reabsorption of phosphate.</p> </details> <details> <summary>Why do some dialysis patients need vitamin D supplementation?</summary> <p>CKD impairs the conversion of vitamin D to its active form, leading to hypocalcemia and secondary hyperparathyroidism. Supplementation is needed to increase active vitamin D levels, improving calcium absorption and managing PTH levels.</p> </details> <details> <summary>What are the consequences of impaired kidney function on phosphate in CKD?</summary> <p>Impaired kidney function leads to phosphate accumulation, which can result in bone disease and contribute to cardiovascular disease by causing calcium-phosphate precipitation in blood vessels.</p> </details> <details> <summary>How are elevated phosphate levels managed in dialysis patients?</summary> <p>Management includes the use of phosphate binders to reduce gastrointestinal phosphate absorption and dietary restrictions to lower phosphate intake.</p> </details>