The classic book on this subject, published by D.S. Initial publications highlighted that patients suffering from these diseases had a negative calcium balance due to reduced intestinal absorption, which is dependent on vitamin D, and that poor calcium absorption was one of the causes of secondary hyperparathyroidism 1,2. While phosphorus retention and the importance of its control are concepts that have remained unchanged since their appearance more than 40 years ago, the opinions on the calcium balance in CRF have been less consistent and even controversial. These are very often completely different to the previous opinions and, at times, emphatically defended by the authors themselves.

The subsequent opinions have always coincided with the appearance of new therapeutic measures on the market.

Alteration in calcium-phosphorus metabolism in chronic renal failure (CRF) is one of the fields within Nephrology that has undergone more changes in terms of theoretical concepts, clinical repercussions and treatment objectives.

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