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Effect of renal function on renal responsiveness to parathyroid hormone in primary hyperparathyroidism and chronic renal failure
Author(s) -
LEWIN I. G.,
HENDY G. N.,
PAPAPOULOS S. E.,
TOMLINSON S.,
O'RIORDAN J. L. H.
Publication year - 1985
Publication title -
european journal of clinical investigation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.164
H-Index - 107
eISSN - 1365-2362
pISSN - 0014-2972
DOI - 10.1111/j.1365-2362.1985.tb00141.x
Subject(s) - parathyroid hormone , medicine , chronic renal failure , primary hyperparathyroidism , renal function , hyperparathyroidism , endocrinology , secondary hyperparathyroidism , hormone , urology , calcium
Abstract. The effect of renal function on the cyclic AMP (cAMP) response to exogenous parathyroid hormone (PTH) was examined in patients with chronic renal failure ( n = 22) and primary hyperparathyroidism ( n = 19). In the patients with chronic renal failure there was marked resistance to the effect of exogenous PTH. In primary hyperparathyroidism the cAMP responses were variable; most of the patients with an abnormally small response having impaired renal function. After parathyroidectomy, responsiveness improved to varying degrees. In three patients repeatedly tested up to several months after parathyroidectomy, the recovery of responsiveness was a gradual process which began within days but did not, however, return to normal. Thus, there was an irreversible component to the resistance to PTH in these patients. A strong negative correlation between plasma creatinine and the cAMP response to PTH ( P < 0·001) was found in a group of patients, some with treated primary hyperparathyroidism and some with chronic renal failure. Thus, renal impairment is an important, but probably not the sole, contributory factor involved in the irreversible resistance to the action of PTH in hyperparathyroidism.