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. 2021 Feb 5;71(3):604–610. doi: 10.1007/s12020-021-02615-2

Fig. 1.

Fig. 1

a *Intravascular fluid expansion causes gestational hypoalbuminemia. The dilutional hypoalbuminemia of pregnancy leads to a decline in total calcium concentration. Ionized calcium on the other hand, remains stable and may provide more accurate information. ** The increase in 1.25 vitamin D production leads to an increase in intestinal calcium absorption. ***“Absorptive hypercalciuria of pregnancy”. Postprandial and 24-h urinary calcium excretion increase after 12 weeks, due to increased intestinal calcium absorption supposedly unrelated to increased formation of 1.25 vitamin D in early pregnancy. Fasting urine samples will not be affected by this phenomenon [45]. b *Prednison to reduce 1.25OH formation and thus intestinal calcium absorption. ** Reducing PTH-rp production mammae. *** No clinical data during pregnancy, only case reports. In animal studies no abnormalities observed, but it does pass the placenta [31, 46]. Breastfeeding: in animal studies (rat), cinacalcet is found in milk [46].