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DOI: 10.1055/s-2007-1012352
© Georg Thieme Verlag, Stuttgart · New York
The Renal Sensitivity for Endogenous Parathormone in Patients with Primary Hyperparathyroidism, Vitamin D Deficiency and Renal Stones
Publication History
1985
1985
Publication Date:
23 April 2008 (online)
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Summary
Baseline levels and increases in urinary cyclic AMP excretion (UcAMP) and immunoreactive parathormone (iPTH) were studied before and during infusion of EDTA in euparathyroid patients with renal stones (n=11), patients with primary hyperparathyroidism (PHP;n=14) and patients with vitamin D deficiency (n=12).
In all three groups, EDTA evoked a significant rise in iPTH and UcAMP. In patients with PHP and in those with vitamin D deficiency, there was a sufficiently close relationship between increments in iPTH (Δ iPTH) and in UcAMP(ΔUcAMP) (r=0.90, P < 0.001 and r=0.67, P < 0.02, respectively) to use this model to assess renal sensitivity for changes to endogenous PTH levels.
We quantified sensitivity of the kidney for PTH, by calculating the ratio ΔUcAMP/ΔTPTH for the three studied groups. The ratio was comparable in patients with renal stones (16.7±10.3)and PHP (13.8±4.9, P > 0.10), but was significantly increased in patients with vitamin D deficiency (33.2±17.9; P < 0.01 versus patients with renal stones and P < 0.01 versus patients with PHP).
Within the group of patients with PHP there was no correlation between baseline serum calcium concentrations and the ratio ΔUcAMP/ΔTPTH.
It is concluded that in patients with vitamin D deficiency, renal sensitivity to PTH is increased compared with patients with PHP and euparathyroid patients with renal stones, perhaps an expression of a teleological useful adaption of end organ sensitivity.
Key-Words
Parathormone - Vitamin D - cAMP