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Proposed role of sclerostin in the regulation of calcium reabsorption in the kidney. (A) Proposed physiologic adaptations to a low-calcium diet. The sequence of changes in hormones is similar to that shown in Figure 1B, except that the effects of PTH on sclerostin concentrations, and the effect of sclerostin on tubular transport and 1α,25(OH)2D synthesis, are now superimposed. (B) The mechanism by which sclerostin influences calcium reabsorption in the distal tubule.
