Renal Insufficiency and Secondary Hyperparathyroidism in Elderly Patients

Turner, G. A.; Rc, Brown; Silver, A; Seymour, G. J.; Js, Woodhead

doi:10.1177/000456329102800401

Cited by 11 publications

(9 citation statements)

References 13 publications

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“…There were patients with secondary HPTH who had vitamin D deficiency and relatively normal renal function and patients with secondary HPTH caused by renal insufficiency who had normal vitamin D levels. These data are consistent with other studies 14–16 and suggest that secondary HPTH in older people is a heterogeneous disorder, which, in this study, was caused in about equal proportions by vitamin D deficiency and renal insufficiency. Age‐related renal disease may contribute to bone loss and fractures in older people independent of vitamin D deficiency, but this requires further study.…”

Section: Discussionsupporting

confidence: 94%

Secondary Hyperparathyroidism in Patients from Western Australia with Hip Fracture: Relationship to Type of Hip Fracture, Renal Function, and Vitamin D Deficiency

Bruce

John

Nicklason

et al. 1999

J American Geriatrics Society

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Secondary hyperparathyroidism appears to be a heterogeneous condition, caused in approximately equal proportions by vitamin D deficiency and renal dysfunction, that may confer increased cortical bone fragility and trochanteric fractures. Renal dysfunction in old age may be an important additional determinant of senile osteoporosis, which has implications for preventive therapy. Vitamin D deficiency occurs in disabled and, presumably, housebound older people despite near optimal climatic conditions.

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Section: Discussionsupporting

confidence: 94%

Secondary Hyperparathyroidism in Patients from Western Australia with Hip Fracture: Relationship to Type of Hip Fracture, Renal Function, and Vitamin D Deficiency

Bruce

John

Nicklason

et al. 1999

J American Geriatrics Society

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“…Serum calcium was corrected for the albumin level. Plasma PTH was measured using a twosite assay for the intact molecule (Ciba-Corning Diagnostics, Halstead, UK) as described previously [9,10], with a reference range of 0.9-5.4 pmol/1. The inter-and intra-assay variations at 2.9 pmol/1 are 9% and 7.2% respectively, and at 39.2 pmol/1 are 5.4% and 3.4% respectively [10].…”

Section: Methodsmentioning

confidence: 99%

Reliability of parathyroid hormone measurements in the period immediately following hip fracture

Johansen¹,

Stone²,

O'Mahony³

et al. 1997

Age Ageing

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“…Measurement of parathyroid hormone Intact PTH was measured by immunochemiluminometric assay (Magic Lite ; Ciba Corning Diagnostics, Halstead, Essex). The adult reference range for non-pregnant individuals is 0.8-5.4 pmol/l (Turner et al 1991). However, in view of a previous study (Davis et al 1988) which showed reduced levels of PTH in pregnant women, a cut-off of 4 pmol/l was selected as the upper reference value in our investigation.…”

Section: Patients and Blood Samplesmentioning

confidence: 99%

“…All samples that yielded high PTH had 250HD estimated by competitive-protein-binding assay following sample extraction (Medgenix Diagnostics, 6220-Fleurus, Belgium). The reference for normal adults is 8-50 ng/ml (Turner et al 1991).…”

Section: Patients and Blood Samplesmentioning

confidence: 99%

Vitamin D deficiency: a concern in pregnant Asian women

et al. 1995

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Vitamin D status of Asian mothers in Cardiff was investigated during early pregnancy and at the time of the birth of their babies, using serum parathyroid hormone (PTH). Median values in Asian (n 32) and Caucasian (n 63) mothers in early pregnancy were 1.56 and 0.81 pmol/l respectively. PTH levels from a separate sample of nineteen Asian and twenty-five Caucasian mothers at the time of birth were 3.0 and 2.20 pmol/l respectively. Altogether twelve Asian and two Caucasian women had elevated PTH. All Asian women who had high PTH values also had a very low serum 25-hydroxycholecalciferol level (250HD). AU samples were taken from women with no significant medical history and normal obstetric history. These findings suggest that subclinical vitamin D deficiency is still a cause for concern in Asian women. More active measures need to be taken to implement current recommendations to improve their vitamin D intake in pregnancy.Parathyroid hormone: Vitamin D: Pregnancy Vitamin D deficiency can occur whenever the demand for the vitamin exceeds supply, as in periods of rapid growth in fetal life, infancy, early childhood and puberty and during pregnancy, lactation and in the elderly. It was the vulnerability of the growing child to rickets that prompted, in the 1940s, fortification of certain foods with vitamin D with or without Ca, and supplements in the form of cod-liver oil being made available free of charge. Tablets which contained vitamins A and D, Ca,(PO,), and KI were provided free for all mothers during pregnancy and for 30 weeks after delivery. Yet in spite of these measures a small number of cases continued to occur among British infants and young children living in poor social conditions where mothers failed to appreciate the need for vitamin supplements, and when household milk containing small amounts of vitamin D was offered as a substitute for human milk or fortified artificial milks (Department of Health and Social Security, 1980). However, since the early 1960s nutritional rickets has been identified mostly, but not exclusively, in immigrant families, mainly Asians. Prevalences of biochemical and clinical rickets in Glasgow's Asian children of 50 and 5 % respectively were reported in the 1960s and 1970s (Ford et al. 1972;Goel et al. 1976). In Birmingham in the mid 1980s, 40 % of 145 Asian toddlers aged 22 months had low serum vitamin D levels (Grindulis et al. 1986). Osteomalacia has been reported also in Asian women of child-bearing age who had lived for some years in Britain (Stamp et al. 1980) including those who were pregnant (Holmes et al. 1973). Brooke et al. (1980) in a study of vitamin D supplements in pregnant Asian women living in London showed a high incidence of vitamin D deficiency during the last trimester; 37% of 126 women had 25-hydroxycholecalciferol(250HD) concentrations below 4 n g / d at 28-32 weeks gestation.

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Renal Insufficiency and Secondary Hyperparathyroidism in Elderly Patients

Cited by 11 publications

References 13 publications

Secondary Hyperparathyroidism in Patients from Western Australia with Hip Fracture: Relationship to Type of Hip Fracture, Renal Function, and Vitamin D Deficiency

Secondary Hyperparathyroidism in Patients from Western Australia with Hip Fracture: Relationship to Type of Hip Fracture, Renal Function, and Vitamin D Deficiency

Reliability of parathyroid hormone measurements in the period immediately following hip fracture

Vitamin D deficiency: a concern in pregnant Asian women

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