<prompt> A child presented with decreased S.Calcium, increased S.Phosphorus and decreased urinary calcium and phosphorus. These are seen in which condition?Renal tubular acidosisChronic Renal failureNutritional ricketsCoeliac rickets  <response>: 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 