Kristoffersson A, Backman C, Granqvist K, Järhult J
Department of Surgery, Umeå University Hospital, Sweden.
J Intern Med. 1990 May;227(5):317-24. doi: 10.1111/j.1365-2796.1990.tb00166.x.
Renal function was investigated immediately before and 1 year following parathyroidectomy in 19 patients with moderate hypercalcaemia. On both occasions, all patients underwent five different tests of glomerular and tubular function: plasma creatinine, creatinine clearance, 51Cr-EDTA-clearance, beta 2-microglobulin excretion and the desmopressin test. Glomerular filtration rate, as assessed by plasma creatinine and clearance of both creatinine and 51Cr-EDTA, was normal in most patients, and was little affected by restoration of normocalcaemia. Renal concentrating capacity, as determined by the desmopressin test, was abnormally low in 14 of 19 patients, but increased significantly after surgery. It is concluded that serious renal damage is seldom encountered in present-day HPT patients, but that a treatable decrease in renal concentrating capacity often exists.
对19例中度高钙血症患者在甲状旁腺切除术前及术后1年立即进行肾功能研究。在这两个时间点，所有患者均接受了五项不同的肾小球和肾小管功能测试：血浆肌酐、肌酐清除率、51Cr-乙二胺四乙酸清除率、β2-微球蛋白排泄及去氨加压素试验。通过血浆肌酐以及肌酐和51Cr-乙二胺四乙酸清除率评估的肾小球滤过率在大多数患者中正常，且很少受到血钙正常化的影响。通过去氨加压素试验测定的肾脏浓缩能力在19例患者中的14例异常低下，但术后显著增加。结论是，在当今的原发性甲状旁腺功能亢进症患者中很少遇到严重的肾脏损害，但常常存在可治疗的肾脏浓缩能力下降。
