Family Nurse Practitioner Exam

Which factor may increase the risk of developing hypocalcemia?

1. Chronic renal failure

2. Exercise and activity

3. High dietary calcium intake

4. Dehydration

The correct answer is: Chronic renal failure

Chronic renal failure is closely associated with an increased risk of developing hypocalcemia due to impaired kidney function. The kidneys play a critical role in maintaining calcium homeostasis by regulating calcium excretion and reabsorption. In chronic renal failure, there is often a decrease in the production of active vitamin D (calcitriol), which is essential for calcium absorption in the intestines. Additionally, the kidneys may be less effective at excreting phosphate, leading to an increase in serum phosphate levels that binds to calcium, further contributing to lower serum calcium levels. As a result, patients with chronic renal failure frequently experience hypocalcemia. The other factors mentioned do not typically have the same direct impact on calcium levels. Regular exercise can actually promote bone and muscle health, potentially supporting calcium metabolism. High dietary calcium intake generally helps to maintain or increase calcium levels unless there is a malabsorption issue or specific underlying condition. Dehydration may lead to various electrolyte imbalances, but it does not directly cause hypocalcemia in the same manner as impaired kidney function.