Relationship Between the Kidney and Parathyroid Hormone

Massry, Shaul G.; Coburn, Jack W.; Friedler, Robert M.; Kurokawa, Kiyoshi; Singer, Frederick R.

doi:10.1159/000180513

Cited by 20 publications

(4 citation statements)

References 41 publications

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“…The four subjects of the first group with normal calcaemia, normal phosphataemia and without osteodystrophy, showed a satisfactory increase in calcaemia (from 18.5% to 20.8%) with good suppression of PTH (an average decrease of 42.8%) during Howard's test. This represents a physiological response by the hyperfunctioning parathyroids, without however the hormone returning to normal levels [16]. On the contrary, in the two subjects in the second group with hypocalcaemia, hyperphosphataemia and osteodystrophy, the increase in calcaemia (0.7 and 0.9% respectively) and suppression of PTH are both insignificant.…”

Section: Discussionmentioning

confidence: 89%

Parathyroid hormone and calcitonin secretion in uraemic infants

1978

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In six infants aged between 4 and 8 months with chronic renal failure, we have studied blood levels of calcium (Ca), phosphorus (P), alkaline phosphatase, immunoreactive parathyroid hormone (PTH), and calcitonin (CT), as well as urinary excretion of Ca, P, hydroxyproline and cyclic AMP under basal conditions and during an infusion of 20 mg/kg of 10% Ca gluconate in normal saline over 4 h. Under basal conditions four infants had normal serum Ca and P values, alkaline phosphatase levels at the upper limit of normal, and very high PTH (range: 1450--2550 pg Eq/ml) and CT (range: 700--1900 pg/ml) levels. The urinary Ca excretion was low, whereas the urinary excretion of P, hydroxyproline and cyclic AMP was high. During Ca infusion, the total serum Ca and CT levels increased, PTH fell without however reaching the normal upper limit, and urinary P and cyclic AMP excretion decreased. In two infants with osteodystrophy and the highest levels of PTH (2900 and 3500 pg Eq/ml respectively) there was no suppression of PTH during Ca infusion.

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Section: Discussionmentioning

confidence: 89%

Parathyroid hormone and calcitonin secretion in uraemic infants

1978

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“…noted that many contradictory results have been published (13). One possible clinical model to observe PTH action on renal function is its clinical use in osteoporosis treatment.…”

Section: Discussionmentioning

confidence: 99%

Transitory increase in creatinine levels after parathyroidectomy: evidence of another action of the parathyroid glands?

Montenegro

Brandão

Ferreira³

et al. 2011

Arq Bras Endocrinol Metab

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Objective: Little information is available on glomerular function changes after surgical treatment of primary hyperparathyroidism. The acute effects of some head and neck operations on renal function were studied. Materials and methods: Retrospective analysis of changes in creatinine levels and estimated glomerular filtration rate (eGFR) after surgery. Preoperative values were compared with values available until 72 hours after the operation. Results: In tertiary hyperparathyroidism, mean preoperative and postoperative eGFR values were 57.7 mL/min and 40.8 mL/min (p < 0.0001), respectively. A similar decrease was observed after parathyroidectomy for primary hyperparathyroidism, from 85.4 mL/min to 64.3 mL/min (p < 0.0001). After major head and neck procedures, there was a slight increase in eGFR (from 94.3 mL/min to 105.4 mL/min, p = 0.002). Conclusions: Parathyroidectomy may be followed by a transient decrease in eGFR that is not often observed in other head and neck operations. Arq Bras Endocrinol Metab. 2011;55(4):249-55 Keywords Creatinine; hyperparathyroidism; acute kidney failure; parathyroid hormone; parathyroidectomy RESUMO Objetivo: Há pouca informação sobre alterações da função glomerular após o tratamento cirúrgico do hiperparatireoidismo primário. O efeito agudo sobre a função renal foi estudado após algumas operações em cirurgia de cabeça e pescoço. Materiais e métodos: Análise retrospectiva dos níveis de creatinina e da taxa de filtração glomerular estimada (eGFR). Os valores pré-operatórios foram comparados aos valores disponíveis até 72 horas após a operação. Resultados: No hiperparatireoidismo terciário, os valores médios pré e pós-operatórios da eGFR foram 57,7 mL/min e 40,8 mL/min (p < 0,0001), respectivamente. O decréscimo após paratireoidectomia por hiperparatireoidismo primário foi de 85,4 mL/min para 64,3 mL/min (p < 0,0001). Após operações maiores de cabeça e pescoço, houve leve elevação da eGFR (de 94,3 mL/min para 105,4 mL/min, p = 0,002). Conclusões: A paratireoidectomia pode ser seguida de uma redução transitória na eGFR que não é frequentemente observada após outras operações em cabeça e pescoço. Arq Bras Endocrinol Metab. 2011;55(4):249-55 Descritores Creatinina; hiperparatireoidismo; falência renal aguda; hormônio paratireoideo; paratireoidectomia

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“…The relative re-sistance to high calcium concentrations, high serum calciumlserum creatinine ratios, seen in hyperparathyroidism (17) could be explained b y a protective effect of PTH. Through a direct effect, PTH could increase renal blood flow and glomerular fdtration rate (22). Indirectly, PTH could improve glomerular filtration rate through an increased tubular reabsorption of calcium, reduced hypercalciuria and diminished tubular obstruction.…”

Section: Monthsmentioning

confidence: 99%

Reversible Renal Failure Caused by Hypercalcemia

Lins

1978

Journal of Internal Medicine

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ABSTRACT. The influence of hypercalcemia on renal function was studied retrospectively in 13 patients suffering from primary hyperparathyroidism, sarcoidosis, vitamin D intoxication, malignant lymphoma or chronic lymphatic leucemia. Different kinds of treatment, depending upon the primary disease, often induced a rapid fall in the serum calcium concentration. The serum creatinine concentration always fell simultaneously. The serum phosphate concentration fell in all but two patients. Changes in serum calcium and serum creatinine correlated significantly (p <0.001), as did changes in serum calcium and serum phosphate concentrations (p <0.05). Serum calcium/serum creatinine and serum calcium/serum phosphate ratios were significantly higher in patients with primary hyperparathyroidism than in patients with hypercalcemia of non‐hyperparathyroid origin (p <0.01, p <0.001). This suggests a different effect of calcium on the glomerular filtration rate in hyperparathyroid and non‐hyperparathyroid patients, the latter group being more sensitive to the influence of hypercalcemia. Possible explanations for this difference, such as a protective effect of PTH on the glomerular filtration, are discussed.

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Relationship Between the Kidney and Parathyroid Hormone

Cited by 20 publications

References 41 publications

Parathyroid hormone and calcitonin secretion in uraemic infants

Parathyroid hormone and calcitonin secretion in uraemic infants

Transitory increase in creatinine levels after parathyroidectomy: evidence of another action of the parathyroid glands?

Reversible Renal Failure Caused by Hypercalcemia

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