A high PTH levels affects which of the following processes to return plasma calcium levels toward normal?
PTH acts directly on bone to increase bone resorption and mobilize Ca2+. In addition to increasing plasma Ca2+, PTH increases phosphate excretion in the urine and thereby suppresses plasma phosphate levels. PTH also increases reabsorption of Ca2+ in the distal tubules, although Ca2+ excretion in the urine is often increased in hyperparathyroidism because the increase in the load of filtered calcium overwhelms the effect on reabsorption. PTH also increases the formation of 1,25-dihydroxycholecalciferol, and this increases Ca2+ absorption from the intestine. On a longer time scale, PTH stimulates both osteoblasts and osteoclasts. Ref: Barrett K.E., Barman S.M., Boitano S., Brooks H.L. (2012). Chapter 21. Hormonal Control of Calcium & Phosphate Metabolism & the Physiology of Bone. In K.E. Barrett, S.M. Barman, S. Boitano, H.L. Brooks (Eds), Ganong's Review of Medical Physiology, 24e.