Importance of Calcium and Phosphorus in Bone Disorders: Clinical and Laboratory Perspectives

Rahul Eshi1*, Shekhar Vasaikar1, Khushal Kalyan Chaudhari2, Lilachand Bhaidas Patil2

1Assistant Professor, P.G. College of Pharmaceutical Science and Research, Chaupale, Nandurbar (MS), India
2Lecturer, K D Gavit D. Pharmacy College, Pathrai, Nandurbar (MS), India

Received: 15 Dec 2025 | Published: 01 Jan 2026
Manuscript No: HJBMR-06-25-008 | Download PDF

Abstract

Calcium and phosphorus are essential minerals responsible for skeletal development, bone mineralization, and metabolic homeostasis. Disruption in their balance leads to disorders such as rickets, osteomalacia, osteoporosis, and hyperparathyroidism. This review discusses the clinical, morphological, biochemical, and pathophysiological aspects of calcium- and phosphorus-related bone disorders, with emphasis on hormonal regulation and the laboratory’s role in diagnosis, monitoring, and prevention.

Keywords

Calcium–phosphorus metabolism, Rickets, Osteomalacia, Osteoporosis, Parathyroid hormone, Vitamin D deficiency, Bone disorders, Laboratory diagnosis

Introduction

Calcium and phosphorus are critical for maintaining skeletal integrity and normal physiological function. Their homeostasis is regulated by parathyroid hormone, vitamin D, and calcitonin. Disturbances in this balance result in significant metabolic and skeletal disorders.

Biological Importance of Calcium and Phosphorus

Calcium is essential for neuromuscular activity, blood coagulation, and enzyme function, while phosphorus plays a key role in energy metabolism, nucleic acid synthesis, and cell membrane integrity. Together, they form hydroxyapatite crystals in bone.

Absorption, Distribution, and Excretion

Calcium and phosphorus are absorbed in the intestine under vitamin D regulation, distributed through blood and bone reservoirs, and excreted primarily via the kidneys. Bone serves as a dynamic store to maintain serum concentrations.

Hormonal Regulation

Parathyroid hormone increases serum calcium and decreases phosphate levels. Vitamin D enhances intestinal absorption of both minerals, while calcitonin inhibits bone resorption during hypercalcemia.

Disorders of Calcium and Phosphorus Metabolism

Imbalances result in hypocalcemia, hypercalcemia, rickets, osteomalacia, osteoporosis, and renal osteodystrophy. Clinical manifestations include bone pain, fractures, neuromuscular symptoms, and renal complications.

Laboratory Role in Diagnosis and Monitoring

Laboratory evaluation includes serum calcium, phosphate, alkaline phosphatase, parathyroid hormone, and vitamin D assays. Accurate testing, quality control, and serial monitoring are essential for diagnosis and treatment assessment.

Treatment and Management

Management includes mineral supplementation, vitamin D therapy, bisphosphonates, hormonal correction, and dietary modification. Laboratory monitoring guides therapeutic decisions and prevents complications.

Prevention and Public Health Importance

Adequate nutrition, sunlight exposure, early biochemical screening, and public awareness programs play a vital role in preventing metabolic bone diseases, especially in high-risk populations.

Conclusion

Calcium and phosphorus homeostasis is fundamental to bone health. Early laboratory diagnosis and interdisciplinary collaboration are essential for effective management and improved patient outcomes.

References

  1. Feng X, McDonald JM. Disorders of bone remodeling. Annu Rev Pathol.
  2. Kovacs CS. Calcium and phosphate metabolism. Endotext.
  3. Chanchlani R et al. Rickets in children. Kidney Int Rep.