Lu K C, Shieh S D, Li B L, Chu P, Jan S Y, Lin Y F
Department of Medicine, Tri-Service General Hospital, Taipei, Taiwan, ROC.
Nephron. 1994;67(4):419-24. doi: 10.1159/000188015.
To investigate the effect of rapid correction of chronic metabolic acidosis on circulating intact parathyroid hormone (I-PTH) activity by free calcium clamp in chronic renal failure, 18 patients were enrolled in this study. Metabolic acidosis was corrected by continuous bicarbonate infusion while plasma ionized calcium was clamped at the preinfusion level throughout the entire procedure. The plasma pH, bicarbonate, total CO2, sodium, serum total calcium and 1,25(OH)2 vitamin D3 levels increased significantly while serum concentrations of I-PTH, alkaline phosphatase and albumin showed significant decreases after bicarbonate infusion. The plasma ionized calcium, potassium, serum magnesium and inorganic phosphorus levels showed no significant difference before and after bicarbonate infusion. These results demonstrate that rapid correction of metabolic acidosis attenuates circulating PTH activity in chronic renal failure and may underline the importance of maintaining normal acid-base homeostasis particularly in the presence of secondary hyperparathyroidism.
为研究在慢性肾衰竭患者中通过游离钙钳夹快速纠正慢性代谢性酸中毒对循环中完整甲状旁腺激素（I-PTH）活性的影响，本研究纳入了18例患者。通过持续输注碳酸氢盐纠正代谢性酸中毒，同时在整个过程中将血浆离子钙钳夹在输注前水平。输注碳酸氢盐后，血浆pH值、碳酸氢盐、总二氧化碳、钠、血清总钙和1,25(OH)2维生素D3水平显著升高，而血清I-PTH、碱性磷酸酶和白蛋白浓度显著降低。输注碳酸氢盐前后血浆离子钙、钾、血清镁和无机磷水平无显著差异。这些结果表明，快速纠正代谢性酸中毒可减弱慢性肾衰竭患者循环中PTH的活性，这可能凸显了维持正常酸碱平衡的重要性，尤其是在继发性甲状旁腺功能亢进的情况下。
