Ko Benjamin, Bergsland Kristin, Gillen Daniel L, Evan Andrew P, Clark Daniel L, Baylock Jaime, Coe Fredric L, Worcester Elaine M
Department of Medicine, University of Chicago School of Medicine, Chicago, Illinois;
Department of Statistics, University of California, Irvine, California; and.
Am J Physiol Regul Integr Comp Physiol. 2015 Jul 1;309(1):R85-92. doi: 10.1152/ajpregu.00071.2015. Epub 2015 May 6.
Idiopathic hypercalciuria (IH) is a common familial trait among patients with calcium nephrolithiasis. Previously, we have demonstrated that hypercalciuria is primarily due to reduced renal proximal and distal tubule calcium reabsorption. Here, using measurements of the clearances of sodium, calcium, and endogenous lithium taken from the General Clinical Research Center, we test the hypothesis that patterns of segmental nephron tubule calcium reabsorption differ between the sexes in IH and normal subjects. When the sexes are compared, we reconfirm the reduced proximal and distal calcium reabsorption. In IH women, distal nephron calcium reabsorption is decreased compared to normal women. In IH men, proximal tubule calcium reabsorption falls significantly, with a more modest reduction in distal calcium reabsorption compared to normal men. Additionally, we demonstrate that male IH patients have lower systolic blood pressures than normal males. We conclude that women and men differ in the way they produce the hypercalciuria of IH, with females reducing distal reabsorption and males primarily reducing proximal tubule function.
特发性高钙尿症（IH）是肾结石患者中常见的家族性特征。此前，我们已经证明高钙尿症主要是由于肾近端和远端小管钙重吸收减少所致。在此，我们利用从综合临床研究中心获取的钠、钙和内源性锂清除率测量数据，检验IH患者与正常受试者之间节段性肾小管钙重吸收模式在性别上存在差异这一假设。当对性别进行比较时，我们再次证实近端和远端钙重吸收减少。在IH女性中，与正常女性相比，远端肾单位钙重吸收减少。在IH男性中，近端小管钙重吸收显著下降，与正常男性相比，远端钙重吸收的减少幅度较小。此外，我们证明男性IH患者的收缩压低于正常男性。我们得出结论，女性和男性产生IH高钙尿症的方式不同，女性减少远端重吸收，而男性主要减少近端小管功能。
