A child presented with decreased S.Calcium, increased S.Phosphorus and decreased urinary calcium and phosphorus. These are seen in which condition?: (A) Renal tubular acidosis, (B) Chronic Renal failure, (C) Nutritional rickets, (D) Coeliac rickets
Answer is B. Decreased sr. Calcium and increased S . phosphorus and decreased urinary phosphate and calcium excretion occurs in chronic renal failure . At first with the reduction of renal function phosphate balance is initially maintained by increased excretion from normal nephrons . However when gfr falls <25 % blood phosphate level rises and urinary phosphate decreased. Ref : Ghai pediatrics eighth edition pg no 495 - 496