Lim P, Jacob E, Tock E P, Pwee H S
Q J Med. 1977 Jul;46(183):327-38.
Calcium and phosphorus balance studies were performed on 13 nephrotic patients and eight patients during clinical remission of the nephrotic syndrome. Marked impairment of intestinal absorption of calcium was found among nephrotic patients, in eight of whom faecal calcium equalled or exceeded dietary calcium. The mean faecal:dietary calcium ratio of nephrotic patients, 1-06 +/- 0-23 (SD), was significantly higher (p less than 0-005) than that of patients in remission, 0-58 +/- 0-21 (SD). The mean 24-hour urinary excretion of calcium of nephrotic patients, 0-68 +/- 0-68 (SD) mmol, was significantly lower (p less than 0-005) than that of patients in remission, 3-02 +/- 1-91 (SD) mmol. Calciferol administered to three nephrotic patients in the dosage of 1.25 mg per day did not significantly influence intestinal absorption or renal excretion of calcium. There was no difference between the two groups of patients in intestinal absorption or renal excretion of phosphorus; there was net intestinal absorption in all subjects. Quantitative bone histology was studied in seven of the nephrotic patients. None had osteomalacia or osteitis fibrosa, while only one had evidence of mild osteoporosis.
对13例肾病患者和8例处于肾病综合征临床缓解期的患者进行了钙磷平衡研究。发现肾病患者存在明显的肠道钙吸收障碍，其中8例患者的粪便钙含量等于或超过膳食钙含量。肾病患者粪便钙与膳食钙的平均比值为1.06±0.23（标准差），显著高于缓解期患者的0.58±0.21（标准差）（p<0.005）。肾病患者24小时尿钙平均排泄量为0.68±0.68（标准差）mmol，显著低于缓解期患者的3.02±1.91（标准差）mmol（p<0.005）。对3例肾病患者每天给予1.25mg剂量的骨化醇，并未显著影响肠道钙吸收或肾钙排泄。两组患者在肠道磷吸收或肾磷排泄方面没有差异；所有受试者均有肠道净磷吸收。对7例肾病患者进行了定量骨组织学研究。无一例有骨软化症或纤维性骨炎，只有1例有轻度骨质疏松的证据。
