Please use this identifier to cite or link to this item: https://repositorio.unifesp.br/handle/11600/2205
Title: Response to an oral calcium load in nephrolithiasis patients with fluctuating parathyroid hormone and ionized calcium levels
Authors: Gomes, S.a. [UNIFESP]
Lage, A. [UNIFESP]
Lazaretti-Castro, Marise [UNIFESP]
Vieira, J.g.h. [UNIFESP]
Heilberg, Ita Pfeferman [UNIFESP]
Universidade Federal de São Paulo (UNIFESP)
Keywords: Parathyroid hormone
Calcium
Hyperparathyroidism
Hypercalciuria
Nephrolithiasis
Bone mineral density
Issue Date: 1-Sep-2004
Publisher: Associação Brasileira de Divulgação Científica
Citation: Brazilian Journal of Medical and Biological Research. Associação Brasileira de Divulgação Científica, v. 37, n. 9, p. 1379-1388, 2004.
Abstract: the response to an oral calcium load test was assessed in 17 hypercalciuric nephrolithiasis patients who presented elevated parathyroid hormone (PTH) irrespective of the ionized calcium (sCa2+) levels. Blood samples were collected at baseline (0 min) and at 60 and 180 min after 1 g calcium load for serum PTH, total calcium, sCa2+, and 1.25(OH)2D3 determinations. According to the sCa2+ level at baseline, patients were classified as normocalcemic (N = 9) or hypercalcemic (N = 8). Six healthy subjects were also evaluated as controls. Bone mineral density was reduced in 14/17 patients. In the normocalcemic group, mean PTH levels at 0, 60 and 180 min (95 ± 76, 56 ± 40, 57 ± 45 pg/ml, respectively) did not differ from the hypercalcemic group (130 ± 75, 68 ± 35, 80 ± 33 pg/ml) but were significantly higher compared to healthy subjects despite a similar elevation in sCa2+ after 60 and 180 min vs baseline in all 3 groups. Mean total calcium and 1.25(OH)2D3 were similar in the 3 groups. Additionally, we observed that 5 of 9 normocalcemic patients presented a significantly higher concentration-time curve for serum PTH (AUC0',60',180') than the other 4 patients and the healthy subjects, suggesting a primary parathyroid dysfunction. These data suggest that the individual response to an oral calcium load test may be a valuable dynamic tool to disclose a subtle primary hyperparathyroidism in patients with high PTH and fluctuating sCa2+ levels, avoiding repeated measurements of both parameters.
URI: http://repositorio.unifesp.br/handle/11600/2205
ISSN: 0100-879X
Other Identifiers: http://dx.doi.org/10.1590/S0100-879X2004000900013
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