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Calcitriol therapy and calcium-regulated PTH secretion in patients with secondary hyperparathyroidism

Ramirez, J A ; Goodman, W G ; Belin, T R ; Gales, B ; Segre, G V ; Salusky, I B

American journal of physiology: endocrinology and metabolism, 1994-12, Vol.267 (6 Pt 1), p.E961-E967 [Periódico revisado por pares]

United States

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  • Título:
    Calcitriol therapy and calcium-regulated PTH secretion in patients with secondary hyperparathyroidism
  • Autor: Ramirez, J A ; Goodman, W G ; Belin, T R ; Gales, B ; Segre, G V ; Salusky, I B
  • Assuntos: Adolescent ; Calcitriol - pharmacology ; Calcitriol - therapeutic use ; Calcium - blood ; Calcium Gluconate - pharmacology ; Citrates - pharmacology ; Citric Acid ; Female ; Humans ; Hyperparathyroidism, Secondary - drug therapy ; Hyperparathyroidism, Secondary - metabolism ; Male ; Parathyroid Hormone - secretion
  • É parte de: American journal of physiology: endocrinology and metabolism, 1994-12, Vol.267 (6 Pt 1), p.E961-E967
  • Descrição: Calcitriol lowers serum parathyroid hormone (PTH) levels in patients with secondary hyperparathyroidism, but its effect on calcium-regulated PTH release remains controversial. Thus 11 patients with secondary hyperparathyroidism underwent dynamic tests of parathyroid function before and after 4 mo of intermittent calcitriol therapy. Serum calcitriol levels rose from 8 +/- 1 to 55 +/- 9 (SE) pg/ml, P < 0.01, serum total and ionized calcium levels increased, and serum PTH levels decreased from 584 +/- 154 to 154 +/- 31 pg/ml, P < 0.05. The maximum increase in serum PTH during hypocalcemia did not differ before (248 +/- 78 pg/ml) or after (280 +/- 100 pg/ml) treatment, but the increase in PTH, expressed as a percentage of preinfusion values, was greater after treatment (329 +/- 73 vs. 132 +/- 10%, P < 0.05). The decreases in serum PTH during calcium infusions did not differ before (70 +/- 5%) or after (73 +/- 5%) therapy, and the set point for PTH release did not change (1.20 +/- 0.03 vs. 1.23 +/- 0.01 mmol/l, not significant). Calcitriol modifies PTH secretion during hypocalcemia in secondary hyperparathyroidism without affecting the set point for PTH release; although calcitriol lowers serum PTH levels, it may also restore the secretory reserve of hyperplastic parathyroid tissues during hypocalcemia.
  • Editor: United States
  • Idioma: Inglês
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  • Realização: ABCD-USP USP   Logos de Redes Sociais: Freepik

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