Inhibitory Effects of Induced Hypercalcemia on Secretion of Parathyroid Hormone*

Kyle, Laurence H.; Canary, John J.; Mintz, Daniel H.; Léon, Antonio de la Vega de

doi:10.1210/jcem-22-1-52

Cited by 60 publications

(17 citation statements)

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“…The diagnosis of hyperparathyroidism was made by the usual biochemical criteria (14) and was confirmed at surgery in six. The three unoperated patients exhibited hypercalcemia, hypophosphatemia, a low renal tubular reabsorption of phosphate, and responses to phosphate loading (15) and calcium infusion (16), which were consistent with the diagnosis of hyperparathyroidism. The patients with hypoparathyroidism included two females and five males, aged yr. Hypoparathyroidism was idiopathic in two and resulted from surgery in 5 patients.…”

Section: Introductionsupporting

confidence: 55%

Changes in Serum and Urinary Calcium during Treatment with Hydrochlorothiazide: Studies on Mechanisms

Brickman¹,

Massry²,

Coburn³

1972

J. Clin. Invest.

217

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A B S T R A C T Studies were undertaken in man to evaluate the roles of volume depletion and of the parathyroid glands in mediating the changes in serum and urinary calcium which follow the administration of hydrochlorothiazide, 100 mg twice daily, for 4 days. 42 studies were carried out in 16 normal subjects, 9 patients with hyperparathyroidism, and 7 vitamin D-treated subjects with hypoparathyroidism. In six studies in normal subjects, daily sodium losses during thiazide administration were quantitatively replaced, and in six other studies the effect of equivalent sodium losses produced by furosemide was evaluated.Although the magnitude of sodium losses was similar in three groups during therapy with thiazides, urinary calcium fell and urinary phosphorus increased significantly only in normal subjects and those with hyperparathyroidism; no change occurred in patients with hypoparathyroidism. With the replacement of the thiazide-induced sodium losses by NaCl in normals, urinary calcium did not change as urinary sodium increased 4-to 5-fold. Furosemide administration produced similar sodium losses while urinary calcium remained at or above control levels. After correction for changes in plasma protein concentration caused by thiazide-induced hemoconcentration, mean levels of serum calcium were significantly increased only in subjects with hyperparathyroidism and vitamin D-treated patients with hypoparathyroidism.

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Section: Introductionsupporting

confidence: 55%

Changes in Serum and Urinary Calcium during Treatment with Hydrochlorothiazide: Studies on Mechanisms

Brickman¹,

Massry²,

Coburn³

1972

J. Clin. Invest.

217

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“…The data from the present study confirm previous reports [8,11] of a significant decrease in fractional phosphorus excretion following calcium infusion in subjects with normal renal function and demon strate that this effect persists over a period of 8 to 20 hours following the completion o f the infusion. The observation that patients with mild to moderate renal failure (Ccr above 40 ml/min) responded to calcium infusion in a similar manner to that observed in normals in dicates that this procedure may have the same diagnostic merits in detecting parathyroid adenomas in this group of patients as in those with normal renal function.…”

Section: Discussionsupporting

confidence: 92%

“…L 'effet d'une perfusion de calcium sur la calcémie, la phosphorémie et l'excrétion fractionnelle du phosphore (Cp/C o) a été étudié chez 8 sujets nor maux et chez 35 malades ayant une insuffisance rénale plus ou moins avancée. On observa une augmentation significativement moins importante de la calcémie chez les sujets en insuffisance rénale avancée et porteurs de signes radiologiques The fall in urinary excretion of phosphorus which follows a cal cium infusion has been attributed to inhibited secretion of parathyroid hormone [2,8,10,11,16]. On the contrary, absence of such an effect on urinary phosphorus has been thought to indicate autonomy of parathyroid tissue [5,8,11].…”

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“…On observa une augmentation significativement moins importante de la calcémie chez les sujets en insuffisance rénale avancée et porteurs de signes radiologiques The fall in urinary excretion of phosphorus which follows a cal cium infusion has been attributed to inhibited secretion of parathyroid hormone [2,8,10,11,16]. On the contrary, absence of such an effect on urinary phosphorus has been thought to indicate autonomy of parathyroid tissue [5,8,11]. The validity of these conclusions de pends on the presence of certain finite secretory activity of parathyroid glands and on the integrity of renal response to changing levels of parathyroid hormone.…”

mentioning

confidence: 99%

“…The validity of these conclusions de pends on the presence of certain finite secretory activity of parathyroid glands and on the integrity of renal response to changing levels of parathyroid hormone. The effect of calcium infusion on the renal handling of phosphorus and its value in determining functional status of parathyroid glands have been studied primarily in sub jects with normal or near normal renal function [2,8,11]. Studies in patients with renal failure have yielded variable results [6,15].…”

mentioning

confidence: 99%

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Calcium Infusion Test in Renal Failure

Popovtzer¹,

Sg²,

Jw³

et al. 1970

Nephron

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The effect of calcium infusion on serum levels of calcium and phosphorus and on the fractional excretion of phosphorus (Cp/C_cr) was studied in eight normal subjects and in 35 patients with varying degrees of renal failure. The increment in serum calcium in patients with advanced renal failure and radiographic evidence of osteitis fibrosa was significantly less than that observed in patients with a comparable renal function but without evidence for such bone disease. The increase in serum phosphorus usually observed after calcium infusion in normal subjects was also seen in patients with chronic renal disease but was less marked as renal failure worsened. In patients with advanced renal failure and osteitis fibrosa serum phosphorus fell after calcium infusion. The fall in Cp/C_cr following calcium infusion in patients with mild renal failure was similar to that observed in normal subjects (50 to 90%), but was diminished in patients with advanced renal failure; in the latter group the maximal decrements in Cp/C_cr were less than 25% in most patients irrespective of the presence or absence of osteitis fibrosa and overt secondary hyperparathyroidism. The results indicate that in patients with advanced renal failure: (1) the usefulness of changes in Cp/C_cr following calcium infusion as a diagnostic or prognostic guide is questionable ; and (2) the difference in the changes in serum calcium and phosphorus after calcium infusion may prove to be helpful in differentiating between uremic patients with and without marked osteitis fibrosa.

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Excretion of phosphate and calcium. Physiology of their renal handling and relation to clinical medicine

Massry¹

1973

Archives of Internal Medicine

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Inhibitory Effects of Induced Hypercalcemia on Secretion of Parathyroid Hormone*

Cited by 60 publications

References 0 publications

Changes in Serum and Urinary Calcium during Treatment with Hydrochlorothiazide: Studies on Mechanisms

Changes in Serum and Urinary Calcium during Treatment with Hydrochlorothiazide: Studies on Mechanisms

Calcium Infusion Test in Renal Failure

Excretion of phosphate and calcium. Physiology of their renal handling and relation to clinical medicine

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