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Parathyroid hormone changes during phosphorus load in patients with chronic renal insufficiency with low serum parathyroid hormone or adynamic bone disease.
Clin Nephrol. 2001 Jul; 56(1):35-43.CN

Abstract

Adynamic bone disease (ABD) is frequently associated with low serum parathyroid hormone (PTH) concentrations. Many clinical and therapeutic conditions have been associated with ABD, and recently, a low phosphorus intake accompanied by low serum concentration of phosphorus and PTH has been described.

AIM

To evaluate the parathyroid gland response of chronic renal insufficiency patients (CRI) with low serum PTH or ABD to a phosphorus load.

METHODS

We examined the effects of 0.5 and 1.0 g/d of phosphorus load over a period of 60 days in 18 patients with mild CRI with a bone biopsy showing ABD (n = 7) or with low serum PTH (serum intact PTH < or = 40 ng/l) and serum phosphorus < 4.5 mg/dl (n = 11).

RESULTS

Serum intact PTH increased significantly only after 1 g of phosphorus (58.5 to 83 ng/l) with a median percent increase of 72%. PTH secretion increased more in patients with lower basal PTH levels (81%). Serum phosphorus did not change significantly and urinary phosphorus increased from 487 to 1,062 mg/dl (p < 0.05). Significant decreases in serum ionized calcium (from 1.26 to 1.19 mmol/l) and calcitriol (from 34.5 to 24.9 pg/ml) were observed. Changes in PTH were inversely correlated with changes in serum ionized calcium (r = -0.54, p < 0.05) and the final PTH concentrations were positively correlated with changes in serum phosphorus (r= 0.52, p < 0.05).

CONCLUSIONS

The parathyroid glands of chronic renal insufficiency patients with "relative hypoparathyroidism" or ABD responded to a phosphorus load with an increase in serum PTH levels. The decrease in serum ionized calcium and calcitriol as well as minimal changes in serum phosphorus appeared to be involved in this response.

Authors+Show Affiliations

Division of Nephrology, Escola Paulista de Medicina, Federal University of São Paulo, Brazil.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

11499657

Citation

Cuppari, L, et al. "Parathyroid Hormone Changes During Phosphorus Load in Patients With Chronic Renal Insufficiency With Low Serum Parathyroid Hormone or Adynamic Bone Disease." Clinical Nephrology, vol. 56, no. 1, 2001, pp. 35-43.
Cuppari L, Carvalho AB, Lobão RR, et al. Parathyroid hormone changes during phosphorus load in patients with chronic renal insufficiency with low serum parathyroid hormone or adynamic bone disease. Clin Nephrol. 2001;56(1):35-43.
Cuppari, L., Carvalho, A. B., Lobão, R. R., Martini, L. A., Cendoroglo, M., Ventura, R. T., & Draibe, S. A. (2001). Parathyroid hormone changes during phosphorus load in patients with chronic renal insufficiency with low serum parathyroid hormone or adynamic bone disease. Clinical Nephrology, 56(1), 35-43.
Cuppari L, et al. Parathyroid Hormone Changes During Phosphorus Load in Patients With Chronic Renal Insufficiency With Low Serum Parathyroid Hormone or Adynamic Bone Disease. Clin Nephrol. 2001;56(1):35-43. PubMed PMID: 11499657.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Parathyroid hormone changes during phosphorus load in patients with chronic renal insufficiency with low serum parathyroid hormone or adynamic bone disease. AU - Cuppari,L, AU - Carvalho,A B, AU - Lobão,R R, AU - Martini,L A, AU - Cendoroglo,M, AU - Ventura,R T, AU - Draibe,S A, PY - 2001/8/14/pubmed PY - 2002/2/8/medline PY - 2001/8/14/entrez SP - 35 EP - 43 JF - Clinical nephrology JO - Clin Nephrol VL - 56 IS - 1 N2 - UNLABELLED: Adynamic bone disease (ABD) is frequently associated with low serum parathyroid hormone (PTH) concentrations. Many clinical and therapeutic conditions have been associated with ABD, and recently, a low phosphorus intake accompanied by low serum concentration of phosphorus and PTH has been described. AIM: To evaluate the parathyroid gland response of chronic renal insufficiency patients (CRI) with low serum PTH or ABD to a phosphorus load. METHODS: We examined the effects of 0.5 and 1.0 g/d of phosphorus load over a period of 60 days in 18 patients with mild CRI with a bone biopsy showing ABD (n = 7) or with low serum PTH (serum intact PTH < or = 40 ng/l) and serum phosphorus < 4.5 mg/dl (n = 11). RESULTS: Serum intact PTH increased significantly only after 1 g of phosphorus (58.5 to 83 ng/l) with a median percent increase of 72%. PTH secretion increased more in patients with lower basal PTH levels (81%). Serum phosphorus did not change significantly and urinary phosphorus increased from 487 to 1,062 mg/dl (p < 0.05). Significant decreases in serum ionized calcium (from 1.26 to 1.19 mmol/l) and calcitriol (from 34.5 to 24.9 pg/ml) were observed. Changes in PTH were inversely correlated with changes in serum ionized calcium (r = -0.54, p < 0.05) and the final PTH concentrations were positively correlated with changes in serum phosphorus (r= 0.52, p < 0.05). CONCLUSIONS: The parathyroid glands of chronic renal insufficiency patients with "relative hypoparathyroidism" or ABD responded to a phosphorus load with an increase in serum PTH levels. The decrease in serum ionized calcium and calcitriol as well as minimal changes in serum phosphorus appeared to be involved in this response. SN - 0301-0430 UR - https://www.unboundmedicine.com/medline/citation/11499657/Parathyroid_hormone_changes_during_phosphorus_load_in_patients_with_chronic_renal_insufficiency_with_low_serum_parathyroid_hormone_or_adynamic_bone_disease_ L2 - https://medlineplus.gov/kidneyfailure.html DB - PRIME DP - Unbound Medicine ER -