Tuma S N, Mallette L E
J Lab Clin Med. 1983 Aug;102(2):213-9.
To examine the role of the kidneys and parathyroid glands in the development of hypercalcemia after bilateral nephrectomy, changes in serum calcium and iPTH were measured in dogs after bilateral nephrectomy, bilateral ureteral ligation, bilateral nephrectomy of thyroparathyroidectomized animals, or sham operation. Total calcium increased at 24 hr after nephrectomy, remained unchanged after bilateral ureteral ligation or sham surgery, and decreased after nephrectomy of thyroparathyroidectomized dogs. Ionized calcium decreased significantly at 12 hr after nephrectomy or ureteral ligation but returned to normal after 24 to 48 hr. At 72 hr ionized calcium remained normal in the nephrectomized animals but fell significantly in the ureteral ligation animals. At 12 and 24 hr, PTH was significantly higher (4.3- and 2.0-fold, respectively) in the nephrectomized group than in the ureteral ligation group.
(1) the increase in total serum calcium after bilateral nephrectomy in the dog is not accompanied by an increase in ionized calcium; (2) intact parathyroid function is necessary for the increase in total calcium and for the maintenance of ionized calcium after nephrectomy; (3) the presence of the kidneys in the ureteral ligation model prevents the rise in total serum calcium and allows a fall in ionized calcium.
为研究双侧肾切除术后肾脏和甲状旁腺在高钙血症发生中的作用，在双侧肾切除、双侧输尿管结扎、双侧肾切除联合甲状腺甲状旁腺切除的动物或假手术的犬中测量血清钙和iPTH的变化。双侧肾切除术后24小时总钙升高，双侧输尿管结扎或假手术后保持不变，而双侧肾切除联合甲状腺甲状旁腺切除的犬术后总钙降低。双侧肾切除或输尿管结扎后12小时离子钙显著降低，但24至48小时后恢复正常。72小时时，肾切除动物的离子钙保持正常，但输尿管结扎动物的离子钙显著下降。在12和24小时时，肾切除组的PTH显著高于输尿管结扎组（分别为4.3倍和2.0倍）。
（1）犬双侧肾切除术后血清总钙升高并不伴有离子钙升高；（2）完整的甲状旁腺功能对于肾切除术后总钙升高和离子钙维持是必要的；（3）输尿管结扎模型中肾脏的存在可防止血清总钙升高并使离子钙降低。
