Suppression of secondary hyperparathyroidism in uraemia: acute and chronic studies
A study was conducted evaluating the response of serum parathyroid hormone to acute hypercalcaemia and long term administration of 1,25-dihydroxyvitamin D3 (1,25(OH)2D3) in patients receiving maintenance haemodialysis. During infusion of elemental calcium 4 mg/kg/h over four hours in 12 patients not...
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| Veröffentlicht in: | BMJ 1984-01, Vol.288 (6412), p.177-179 |
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| creator | Muirhead, N Catto, G R Edward, N Adami, S Manning, R M O'Riordan, J L |
| description | A study was conducted evaluating the response of serum parathyroid hormone to acute hypercalcaemia and long term administration of 1,25-dihydroxyvitamin D3 (1,25(OH)2D3) in patients receiving maintenance haemodialysis. During infusion of elemental calcium 4 mg/kg/h over four hours in 12 patients not receiving vitamin D the concentration of serum amino terminal parathyroid hormone fell by 31-96% (mean 74.8 (SD 17.6)%) while that of carboxy terminal parathyroid hormone changed little. There was a strong inverse correlation between baseline serum calcium concentration and percentage fall in amino terminal parathyroid hormone during infusion (r = 0.88; p less than 0.001). In seven patients who received prolonged treatment with 1,25(OH)2D3 after calcium infusion there was a positive correlation between maximum percentage fall in amino terminal parathyroid hormone during infusion and the percentage fall in amino terminal parathyroid hormone after 1,25(OH)2D3 treatment (r = 0.79; p less than 0.05). The responsiveness of the parathyroid glands to changes in calcium in acute studies may be used to predict the efficacy of long term treatment with 1,25(OH)2D3. Patients in whom calcium infusion does not suppress parathyroid hormone may have true parathyroid autonomy and require early parathyroidectomy. |
| doi_str_mv | 10.1136/bmj.288.6412.177 |
| format | Article |
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During infusion of elemental calcium 4 mg/kg/h over four hours in 12 patients not receiving vitamin D the concentration of serum amino terminal parathyroid hormone fell by 31-96% (mean 74.8 (SD 17.6)%) while that of carboxy terminal parathyroid hormone changed little. There was a strong inverse correlation between baseline serum calcium concentration and percentage fall in amino terminal parathyroid hormone during infusion (r = 0.88; p less than 0.001). In seven patients who received prolonged treatment with 1,25(OH)2D3 after calcium infusion there was a positive correlation between maximum percentage fall in amino terminal parathyroid hormone during infusion and the percentage fall in amino terminal parathyroid hormone after 1,25(OH)2D3 treatment (r = 0.79; p less than 0.05). The responsiveness of the parathyroid glands to changes in calcium in acute studies may be used to predict the efficacy of long term treatment with 1,25(OH)2D3. Patients in whom calcium infusion does not suppress parathyroid hormone may have true parathyroid autonomy and require early parathyroidectomy.</description><identifier>ISSN: 0007-1447</identifier><identifier>ISSN: 0267-0623</identifier><identifier>ISSN: 0959-8138</identifier><identifier>EISSN: 1468-5833</identifier><identifier>DOI: 10.1136/bmj.288.6412.177</identifier><identifier>PMID: 6419845</identifier><identifier>CODEN: BMJOAE</identifier><language>eng</language><publisher>London: British Medical Journal Publishing Group</publisher><subject>Adult ; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy ; Biological and medical sciences ; Calcitriol - therapeutic use ; Calcium ; Calcium - blood ; Calcium Gluconate ; Clinical Research ; Dialysis ; Emergency and intensive care: renal failure. Dialysis management ; Gluconates ; Hormones ; Humans ; Hyperparathyroidism ; Hyperparathyroidism, Secondary - blood ; Hyperparathyroidism, Secondary - complications ; Hyperparathyroidism, Secondary - surgery ; Hyperparathyroidism, Secondary - therapy ; Intensive care medicine ; Kidney failure ; Medical sciences ; Middle Aged ; Parathyroid glands ; Parathyroid Hormone - blood ; Parathyroidectomy ; Peptide Fragments - blood ; Renal Dialysis ; Secondary hyperparathyroidism ; Thyroid hormones ; Uremia - blood ; Uremia - complications ; Uremia - therapy ; Vitamin D</subject><ispartof>BMJ, 1984-01, Vol.288 (6412), p.177-179</ispartof><rights>Copyright 1984 British Medical Journal</rights><rights>1984 INIST-CNRS</rights><rights>Copyright BMJ Publishing Group LTD Jan 21, 1984</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b4907-e262326e35d7a9d68155557c14b5865d65e7fb485a2cea70e5ae900d3998cd223</citedby><cites>FETCH-LOGICAL-b4907-e262326e35d7a9d68155557c14b5865d65e7fb485a2cea70e5ae900d3998cd223</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.jstor.org/stable/pdf/29513723$$EPDF$$P50$$Gjstor$$H</linktopdf><linktohtml>$$Uhttps://www.jstor.org/stable/29513723$$EHTML$$P50$$Gjstor$$H</linktohtml><link.rule.ids>230,314,727,780,784,803,885,27924,27925,53791,53793,58017,58250</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=9481346$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/6419845$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Muirhead, N</creatorcontrib><creatorcontrib>Catto, G R</creatorcontrib><creatorcontrib>Edward, N</creatorcontrib><creatorcontrib>Adami, S</creatorcontrib><creatorcontrib>Manning, R M</creatorcontrib><creatorcontrib>O'Riordan, J L</creatorcontrib><title>Suppression of secondary hyperparathyroidism in uraemia: acute and chronic studies</title><title>BMJ</title><addtitle>Br Med J (Clin Res Ed)</addtitle><description>A study was conducted evaluating the response of serum parathyroid hormone to acute hypercalcaemia and long term administration of 1,25-dihydroxyvitamin D3 (1,25(OH)2D3) in patients receiving maintenance haemodialysis. During infusion of elemental calcium 4 mg/kg/h over four hours in 12 patients not receiving vitamin D the concentration of serum amino terminal parathyroid hormone fell by 31-96% (mean 74.8 (SD 17.6)%) while that of carboxy terminal parathyroid hormone changed little. There was a strong inverse correlation between baseline serum calcium concentration and percentage fall in amino terminal parathyroid hormone during infusion (r = 0.88; p less than 0.001). In seven patients who received prolonged treatment with 1,25(OH)2D3 after calcium infusion there was a positive correlation between maximum percentage fall in amino terminal parathyroid hormone during infusion and the percentage fall in amino terminal parathyroid hormone after 1,25(OH)2D3 treatment (r = 0.79; p less than 0.05). The responsiveness of the parathyroid glands to changes in calcium in acute studies may be used to predict the efficacy of long term treatment with 1,25(OH)2D3. Patients in whom calcium infusion does not suppress parathyroid hormone may have true parathyroid autonomy and require early parathyroidectomy.</description><subject>Adult</subject><subject>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</subject><subject>Biological and medical sciences</subject><subject>Calcitriol - therapeutic use</subject><subject>Calcium</subject><subject>Calcium - blood</subject><subject>Calcium Gluconate</subject><subject>Clinical Research</subject><subject>Dialysis</subject><subject>Emergency and intensive care: renal failure. Dialysis management</subject><subject>Gluconates</subject><subject>Hormones</subject><subject>Humans</subject><subject>Hyperparathyroidism</subject><subject>Hyperparathyroidism, Secondary - blood</subject><subject>Hyperparathyroidism, Secondary - complications</subject><subject>Hyperparathyroidism, Secondary - surgery</subject><subject>Hyperparathyroidism, Secondary - therapy</subject><subject>Intensive care medicine</subject><subject>Kidney failure</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Parathyroid glands</subject><subject>Parathyroid Hormone - blood</subject><subject>Parathyroidectomy</subject><subject>Peptide Fragments - blood</subject><subject>Renal Dialysis</subject><subject>Secondary hyperparathyroidism</subject><subject>Thyroid hormones</subject><subject>Uremia - blood</subject><subject>Uremia - complications</subject><subject>Uremia - therapy</subject><subject>Vitamin D</subject><issn>0007-1447</issn><issn>0267-0623</issn><issn>0959-8138</issn><issn>1468-5833</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1984</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNqFUUur1DAYDaJch-vduxEKihvpmPfDhSCD4xUvV_AJbkKapk7GtqlJK86_N3WG-tjcbD7CeXC-7wBwH8E1QoQ_rbr9Gku55hThNRLiFlghymXJJCG3wQpCKEpEqbgLLlLa5y8mQipOz8BZlihJ2Qq8ez8NQ3Qp-dAXoSmSs6GvTTwUu8Pg4mCiGXeHGHztU1f4vpiicZ03zwpjp9EVpq8Lu4uh97ZI41R7l-6BO41pk7s4zXPwcfvyw-ayvHr76vXmxVVZUZWTOcwxwdwRVgujai4Ry09YRCsmOas5c6KpqGQGW2cEdMw4BWFNlJK2xpicg-dH32GqOldb14_RtHqIvsv5dTBe_4v0fqe_hh8634QyJLPB45NBDN8nl0bd-WRd25rehSlpCRVWkOEbiYgohBmfHR_-R9yHKfb5Cjr3k49O0G87eGTZGFKKrlkyI6jnZnVuVudm9dzsrMySB3_vughOPWb80Qk3yZq2iaa3Pi00RSUilP-x2acxxAXGiiEiMMl4ecR9Gt3PBTfxm-aCCKavP200__xle3m93eg3mf_kyJ8D37jEL45j0k8</recordid><startdate>19840121</startdate><enddate>19840121</enddate><creator>Muirhead, N</creator><creator>Catto, G R</creator><creator>Edward, N</creator><creator>Adami, S</creator><creator>Manning, R M</creator><creator>O'Riordan, J L</creator><general>British Medical Journal Publishing Group</general><general>British Medical Association</general><general>BMJ Publishing Group LTD</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88I</scope><scope>8AF</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>BTHHO</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>M2P</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7QP</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>19840121</creationdate><title>Suppression of secondary hyperparathyroidism in uraemia: acute and chronic studies</title><author>Muirhead, N ; Catto, G R ; Edward, N ; Adami, S ; Manning, R M ; O'Riordan, J L</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-b4907-e262326e35d7a9d68155557c14b5865d65e7fb485a2cea70e5ae900d3998cd223</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1984</creationdate><topic>Adult</topic><topic>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</topic><topic>Biological and medical sciences</topic><topic>Calcitriol - therapeutic use</topic><topic>Calcium</topic><topic>Calcium - blood</topic><topic>Calcium Gluconate</topic><topic>Clinical Research</topic><topic>Dialysis</topic><topic>Emergency and intensive care: renal failure. Dialysis management</topic><topic>Gluconates</topic><topic>Hormones</topic><topic>Humans</topic><topic>Hyperparathyroidism</topic><topic>Hyperparathyroidism, Secondary - blood</topic><topic>Hyperparathyroidism, Secondary - complications</topic><topic>Hyperparathyroidism, Secondary - surgery</topic><topic>Hyperparathyroidism, Secondary - therapy</topic><topic>Intensive care medicine</topic><topic>Kidney failure</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Parathyroid glands</topic><topic>Parathyroid Hormone - blood</topic><topic>Parathyroidectomy</topic><topic>Peptide Fragments - blood</topic><topic>Renal Dialysis</topic><topic>Secondary hyperparathyroidism</topic><topic>Thyroid hormones</topic><topic>Uremia - blood</topic><topic>Uremia - complications</topic><topic>Uremia - therapy</topic><topic>Vitamin D</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Muirhead, N</creatorcontrib><creatorcontrib>Catto, G R</creatorcontrib><creatorcontrib>Edward, N</creatorcontrib><creatorcontrib>Adami, S</creatorcontrib><creatorcontrib>Manning, R M</creatorcontrib><creatorcontrib>O'Riordan, J L</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Science Database (Alumni Edition)</collection><collection>STEM Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>BMJ Journals</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Research Library</collection><collection>Science Database</collection><collection>Research Library (Corporate)</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>BMJ</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Muirhead, N</au><au>Catto, G R</au><au>Edward, N</au><au>Adami, S</au><au>Manning, R M</au><au>O'Riordan, J L</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Suppression of secondary hyperparathyroidism in uraemia: acute and chronic studies</atitle><jtitle>BMJ</jtitle><addtitle>Br Med J (Clin Res Ed)</addtitle><date>1984-01-21</date><risdate>1984</risdate><volume>288</volume><issue>6412</issue><spage>177</spage><epage>179</epage><pages>177-179</pages><issn>0007-1447</issn><issn>0267-0623</issn><issn>0959-8138</issn><eissn>1468-5833</eissn><coden>BMJOAE</coden><abstract>A study was conducted evaluating the response of serum parathyroid hormone to acute hypercalcaemia and long term administration of 1,25-dihydroxyvitamin D3 (1,25(OH)2D3) in patients receiving maintenance haemodialysis. During infusion of elemental calcium 4 mg/kg/h over four hours in 12 patients not receiving vitamin D the concentration of serum amino terminal parathyroid hormone fell by 31-96% (mean 74.8 (SD 17.6)%) while that of carboxy terminal parathyroid hormone changed little. There was a strong inverse correlation between baseline serum calcium concentration and percentage fall in amino terminal parathyroid hormone during infusion (r = 0.88; p less than 0.001). In seven patients who received prolonged treatment with 1,25(OH)2D3 after calcium infusion there was a positive correlation between maximum percentage fall in amino terminal parathyroid hormone during infusion and the percentage fall in amino terminal parathyroid hormone after 1,25(OH)2D3 treatment (r = 0.79; p less than 0.05). The responsiveness of the parathyroid glands to changes in calcium in acute studies may be used to predict the efficacy of long term treatment with 1,25(OH)2D3. Patients in whom calcium infusion does not suppress parathyroid hormone may have true parathyroid autonomy and require early parathyroidectomy.</abstract><cop>London</cop><pub>British Medical Journal Publishing Group</pub><pmid>6419845</pmid><doi>10.1136/bmj.288.6412.177</doi><tpages>3</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | BMJ, 1984-01, Vol.288 (6412), p.177-179 |
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| language | eng |
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| source | MEDLINE; JSTOR Archive Collection A-Z Listing; PubMed Central |
| subjects | Adult Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy Biological and medical sciences Calcitriol - therapeutic use Calcium Calcium - blood Calcium Gluconate Clinical Research Dialysis Emergency and intensive care: renal failure. Dialysis management Gluconates Hormones Humans Hyperparathyroidism Hyperparathyroidism, Secondary - blood Hyperparathyroidism, Secondary - complications Hyperparathyroidism, Secondary - surgery Hyperparathyroidism, Secondary - therapy Intensive care medicine Kidney failure Medical sciences Middle Aged Parathyroid glands Parathyroid Hormone - blood Parathyroidectomy Peptide Fragments - blood Renal Dialysis Secondary hyperparathyroidism Thyroid hormones Uremia - blood Uremia - complications Uremia - therapy Vitamin D |
| title | Suppression of secondary hyperparathyroidism in uraemia: acute and chronic studies |
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