The kidney plays a pivotal role in regulating calcium levels within the body. Approximately 98% of the filtered calcium is reabsorbed in the nephron, and this process is tightly controlled to maintain calcium homeostasis, which is required to facilitate optimal bone mineralization, preserve serum calcium levels within a narrow range, and support intracellular signalling mechanisms. The maintenance of these functions is attributed to a delicate balance achieved by various calcium channels, transporters, and calcium-binding proteins in renal cells. Perturbation of this balance due to deficiency or dysfunction of calcium channels and calcium-binding proteins can lead to severe complications. For example, polycystic kidney disease is linked to aberrant calcium transport and signalling. Furthermore, dysregulation of calcium levels can promote the formation of kidney stones. This Review provides an updated description of the key aspects of calcium handling in the kidney, focusing on the function of various calcium channels and the physiological stimuli that control these channels or are communicated through them. A discussion of the role of calcium as an intracellular second messenger and the pathophysiology of renal calcium dysregulation, as well as a summary of gaps in knowledge and future prospects, are also included.

肾脏在调节体内钙水平方面起着关键作用。大约 98% 的过滤钙在肾单位中被重吸收，这个过程受到严格控制以维持钙稳态，这是促进最佳骨矿化、将血清钙水平保持在狭窄范围内并支持细胞内信号传导机制所必需的。这些功能的维持归因于肾细胞中各种钙通道、转运蛋白和钙结合蛋白实现的微妙平衡。由于钙通道和钙结合蛋白的缺乏或功能障碍而扰乱这种平衡可能会导致严重的并发症。例如，多囊肾病与钙转运和信号传导异常有关。此外，钙水平失调会促进肾结石的形成。这篇综述提供了肾脏钙处理关键方面的最新描述，重点关注各种钙通道的功能以及控制这些通道或通过它们传达的生理刺激。还讨论了钙作为细胞内第二信使的作用和肾钙失调的病理生理学，以及知识差距和未来前景的总结。