Disorders of Divalent Cation and Mineral Metabolism

I.   Program Content

1. Trainees must acquire knowledge and understanding of the following areas during the course of their training:

1. Calcium and phosphorus balance in humans.

2. Renal handling of calcium, magnesium and phosphorus.

3. Physiology of calcitropic hormones, specifically parathyroid hormone, vitamin D, calcitonin, and parathyroid hormone-related peptide.

4. An integrated view of calcitropic hormone regulation in normal situations and in the context of acute and chronic renal failure.

5. Bone physiology.

6. Methods to diagnose and treat different types of renal osteodystrophy, interpretation of bone biopsies, and an experience in the interpretation of bone biopsies in chronic renal disease.

7. Pathogenesis and treatment of calcium nephrolithiasis, urate nephrolithiasis, infected stones, and cystine stones.

8. Surgical procedures necessary for the treatment of stone disease.

II.   Patient Care Experience

1. Trainees should also be familiar with, and preferably have experience in, the direct diagnosis and management of the following areas, in both an outpatient and inpatient setting:

1. Trainees must diagnose and manage patients with different types of renal osteodystrophy.

2. Trainees should become familiar with the diagnosis and management of hyper-and hypocalcemia, hyper- and hypophosphatemia, and hypo- and hypermagnesemia.

3. Training should include a significant exposure to the diagnosis and management of various forms of nephrolithiasis.

4. Trainees should be familiar with the interpretation of bone biopsies.