[The pathogenesis of hypercalciuria from the aspect of the response to human parathyroid hormone in Ca containing stone formers].
In order to clarify the pathogenesis of hypercalciuria, the response to extrinsic human parathyroid hormone (h-PTH) was studied the 21 patients with calcium containing urinary stone(s) and 5 normal controls (NO). The stone patients were classified into 3 groups from the result of the oral calcium loading test, i.e. Non-hypercalciura (NH, n = 8) and absorptive hypercalciuria (AH, n = 8) and renal hypercalciuria (RH, n = 5). Only in the AH group, urinary excretion of calcium (u-Ca) was strongly correlated to that of sodium (u-Na) in pre-load of h-PTH, and both increments were also correlated in post-load of h-PTH. As of this fact the increase in Na excretion seems to be responsible for a cause of hypercalciuria in the AH group. There was a significant correlation between the value of %TRP in pre-load of h-PTH and the rate of urinary phosphorus (P) increment between pre-load and post-load of h-PTH in the NO and NH groups. However, this relationship was not found in the AH and RH groups. These findings indicate that there is response disorder of P to h-PTH. In addition, serum P was low, plasma 1,25 (OH)2D was high, N-c-AMP was low in the AH group, whereas both serum P and %TRP were low in the RH group in pre-load of h-PTH. These findings are compatible with the primary renal P leak.(ABSTRACT TRUNCATED AT 250 WORDS)
Taguchi
K
K
Department of Urology, Tohoku University School of Medicine.
Kuwahara
M
M
Kambe
K
K
Ioritani
N
N
Saitoh
T
T
Shirai
S
S
Orikasa
S
S
Mizunashi
K
K
Furukawa
Y
Y
D000328:Adult; D002118:Calcium / Q000032:analysis / Q000652:urine*; D005260:Female; D006801:Humans; D007669:Kidney Calculi / Q000503:physiopathology / Q000652:urine*; D008297:Male; D008875:Middle Aged; D010281:Parathyroid Hormone / Q000494:pharmacology*; D011188:Potassium / Q000652:urine; D012964:Sodium / Q000652:urine
D010281:Parathyroid Hormone; D012964:Sodium; D011188:Potassium; D002118:Calcium