Hypercalcaemia Discrimination Index: A Multivariate Analysis of Parathyroid Function in 107 Hypercalcaemic Patients

Transbøl, Ib; Fs, Jorgensen; Hornum, I.; Keiding, Niels

doi:10.1530/acta.0.0860768

Cited by 18 publications

(6 citation statements)

References 18 publications

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“…However, when the capacity of PTH to increase the tubular reabsorption of calcium was also taken into account, a subgroup of hypercalcaemic patients with malignant Acta Med Scand 212 disease was clearly separated. Thus, in agreement with the findings by Transb~l et al (29), it appears that calculations of this discrimination index will add information on at least some patients.…”

Section: Discussionsupporting

confidence: 89%

Clinical Studies on Phosphate Handling in Hypercalcaemia

Wíkström

Ljunghall

Wide

et al. 1982

Journal of Internal Medicine

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Section: Discussionsupporting

confidence: 89%

Clinical Studies on Phosphate Handling in Hypercalcaemia

Wíkström

Ljunghall

Wide

et al. 1982

Journal of Internal Medicine

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“…This interpretation is supported by the present finding that despite an enhanced parathyroid function, as in dicted by both the increased serum PTH and urinary NcAMP levels [24], hypertensive patients had a mean total calcium concentration in the serum which was not significantly different from the corresponding mean va lue in the normotensive group.…”

Section: Discussionsupporting

confidence: 78%

Urine Calcium Excretion, Nephrogenous Cyclic-Adenosine Monophosphate and Serum Parathyroid Hormone Levels in Patients with Essential Hypertension

Papagalanis

Skopelitis²,

Kourti³

et al. 1991

Nephron

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To evaluate the role of calcium and the parathyroid gland in the pathophysiology of essential hypertension, creatinine clearance, urinary excretion of sodium, calcium and nephrogenous cyclic adenosine monophosphate (NcAMP) and serum parathyroid hormone (PTH) levels were measured in 25 newly diagnosed essentially hypertensive patients before institution of any treatment and in 25 age- and sex-matched normal volunteers. While no significant differences in creatinine clearance, serum total calcium levels or 24-hour sodium excretion existed between the two groups, hypertensives had a higher mean ( ± SD) 24-hour calcium excretion rate (199.0 ± 44.7 vs. 152.8 ± 33.6 mg, p < 0.001), a higher mean NcAMP excretion rate (2.54 ± 0.8 vs. 1.87 ± 0.5 nmol/l00 ml glomerular filtrate, p < 0.001) and a higher mean serum PTH concentration (1.87 ± 0.6 vs. 1.53 ± 0.4 ng/ml, p < 0.001) than the normotensives. A significant positive correlation existed between calcium and sodium excretion in both hypertensives (r=0.66, p < 0.001)) and normotensives (r = 0.67, p < 0.001), but given the same levels of creatinine clearance and sodium excretion, hypertensives excreted more calcium than normotensives (p < 0.001)). In both hypertensives and normotensives, serum PTH levels were positively correlated with NcAMP excretion (r = 0.42, p < 0.05, and r = 0.41, p < 0.05, respectively) and the ratio of urinary sodium to urinary calcium excretion (r = 0.59, p < 0.001, and r = 0.75, p < 0.001), respectively). The above results suggest that in essential hypertension, increased activity of parathyroid glands may occur as a consequence of increased urinary calcium losses which are presumably due to an intrinsic defect in renal calcium handling.

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“…Measurements of multiple indicators of parathyroid function (PTH, nephrogenous cAMP, ionized calcium and phosphorus) is necessary to accurately define the frequency of parathyroid gland overactivity. 14 Our data indicate that the cAMP/creatinine ratio may be an additional simple screening test for the presence of increased parathyroid activity in hypertensive patients.…”

Section: Discussionmentioning

confidence: 62%

Enhanced parathyroid function in essential hypertension: a homeostatic response to a urinary calcium leak.

McCarron¹,

Pingree²,

Rubin³

et al. 1980

Hypertension

327

123

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SUMMARY Disorders of calcium metabolism are not generally considered important either clinically or patbophysiologkally in essential hypertension. Recent reports, though, suggest that increased parathyroid gland function may be one of the more common endocrine disturbances associated with hypertension. We measured serum parathyroid hormone (PTH) concentrations as well as routine blood and arine chemistries in 34 hypertensives. Their mean PTH, 79.1 ± 3.1 filter Eq/ziUter, was rignlflcaatiy higher {p < 0.025) than the mean PTH, 66.9 ± 33, of an age-and sex-matched nonnotenshe control population. The mean serum calcium, 9.5 ± 0.1 mg%, was identical in the two populations. Compared to a second age-aad sex-matched normotensive population, the hypertensives demonstrated a significant (p < 0.005) relatiTe hypercalduria. For any lerd of urinary sodium, hypertenshes excreted more calcium. These preliminary data suggest that parathyroid gland function may be enhanced in essential hypertension. This increased gland actirity appears, in part, to be an appropriate, physiologic response to a previously unrecognized relative hypercalduria, or renal caldum leak, associated with essential hypertension. We condude that the increased prevalence of hypertension in subjects with byperparathyroidfam probably represents the final event In a continuum that begins with obligatory urinary caldum losses in hypertensives, but whose pathological presentation is hyperparathyroidism. The results of this pilot study indicate a need for derivative experiments directed at defining the importance of our preliminary findings In the patbogenesis of human and experimental hypertension. 1 "' Conversely, the prevalence of hyperparathyroidism may be two to eight times greater in hypertensive than in normotensive subjects. 4-• In addition, thiazide diuretics cause overt hypercalcemia in certain hyper-

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Hypercalcaemia Discrimination Index: A Multivariate Analysis of Parathyroid Function in 107 Hypercalcaemic Patients

Cited by 18 publications

References 18 publications

Clinical Studies on Phosphate Handling in Hypercalcaemia

Clinical Studies on Phosphate Handling in Hypercalcaemia

Urine Calcium Excretion, Nephrogenous Cyclic-Adenosine Monophosphate and Serum Parathyroid Hormone Levels in Patients with Essential Hypertension

Enhanced parathyroid function in essential hypertension: a homeostatic response to a urinary calcium leak.

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