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THE EFFECT OF lα‐HYDROXYVITAMIN D 3 IN PATIENTS WITH CHRONIC RENAL FAILURE, WITH PARTICULAR EMPHASIS ON THE RENAL HANDLING OF PHOSPHATE
Author(s) -
MADSEN SØREN,
ØLGAARD KLAUS
Publication year - 1977
Publication title -
clinical endocrinology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.055
H-Index - 147
eISSN - 1365-2265
pISSN - 0300-0664
DOI - 10.1111/j.1365-2265.1977.tb03367.x
Subject(s) - medicine , endocrinology , parathyroid hormone , alkaline phosphatase , vitamin d and neurology , phosphate , secondary hyperparathyroidism , renal physiology , calcium , hyperphosphatemia , chemistry , kidney , biochemistry , enzyme
SUMMARY The present study was undertaken to elucidate the clinical, skeletal, intestinal and especially the renal effect of lα‐hydroxyvitamin D 3 (lα‐OHD 3 ), a synthetic vitamin D analogue. Seventeen patients in the uraemic state were investigated before and after long‐term treatment (mean 12.6 months) with lα‐OHD 3 . Serum total calcium, serum ionized calcium (Ca 2+ ), phosphorus, alkaline phosphatases, magnesium, parathyroid hormone (iPTH), 241 Am‐photonabsorptiometry, 99m technetium‐polyphosphate scintigraphy, intestinal 47 Calciurn‐absorption and X‐ray survey of the skeleton were measured. In the uraemic patients (dialysed as well as non‐dialysed), a total or partial normalization of the bone‐related parameters was found, including relief of bone pain. In order to evaluate the effect of lα‐OHD 3 on the renal handling of phosphate, ten non‐parathyroidectomized (non‐PTX) and five totally parathyroidectornized (PTX) patients were studied. Both groups were investigated before and after administration of lα‐OHD 3 . The PTX patients were vitamin D depleted and hypocal‐caemic before the study. During P‐infusion, the maximal tubular reabsorption of phosphate (TmP), [ 51 Cr]‐EDTA clearance (GFR), parathyroid hormone (iPTH) and Ca 2+ were measured. The TmP/GFR‐ratio was used as an index of the renal handling of phosphate. It was demonstrated (1)that lα‐OHD 3 exhibits no antiphos‐phaturic effect in man in the absence of PTH, and (2) that the lα‐OHD 3 induced changes in the renal handhg of phosphate are mediated by suppression of iPTH.