Newman G H, Wade M, Hosking D J
Br Med J (Clin Res Ed). 1983 Sep 17;287(6395):781-4. doi: 10.1136/bmj.287.6395.781.
Treatment of hypoparathyroidism usually requires the use of pharmacological doses of parent vitamin D or near physiological amounts of the hydroxylated metabolites, calcitriol or alphacalcidol. Vitamin D intoxication and hypercalcaemia may be a problem but can be minimised by the use of small doses of vitamin D or its metabolites combined with large amounts of oral calcium. The response to treatment can be easily monitored by measuring serum and urinary calcium and creatinine concentrations. This allows the derivation of two simple indices reflecting calcium load presented to the kidney (calcium excretion in mmol/l glomerular filtrate) and renal tubular calcium reabsorption (TmCa/GFR). These can be used to predict the requirement of calcium supplements and also identify those patients at particular risk of hypercalcaemia.
甲状旁腺功能减退症的治疗通常需要使用药理剂量的维生素D原或接近生理量的羟基化代谢产物，即骨化三醇或阿法骨化醇。维生素D中毒和高钙血症可能是个问题，但通过使用小剂量维生素D或其代谢产物并结合大量口服钙剂可将其降至最低。通过测量血清和尿钙及肌酐浓度可轻松监测治疗反应。这可得出两个简单指标，反映肾脏所承受的钙负荷（每升肾小球滤过液中的钙排泄量，单位为毫摩尔）和肾小管钙重吸收（TmCa/GFR）。这些指标可用于预测钙剂补充需求，还可识别那些有高钙血症特殊风险的患者。
