Ponce P, Gusmão L, Adragão T, Bruges M, Gomes E M, Antunes J
Serviço de Nefrologia, Hospital de S. Cruz. Carnaxide.
Acta Med Port. 1994 Apr;7(4):207-10.
To study the effect of the correction of post-transplantation Hypophosphatemia on mineral metabolism.
15 patients with renal transplants for 3 to 12 months, Serum Creatinine "177 micmol/1, were treated with oral phosphorus (P) for persistent hypophosphatemia.
3 periods of blood and urine collection at intervals of 3 weeks. T1 under basal treatment with oral P, T2 after 3 weeks off medication with P, Ca, or P binders. T3 3 weeks after going back on oral P supplements.
Serum P dropped from T1 to T2 (1.03 +/- 0.03 mmol/L to 0.83 +/- 0.03 mmol/L, p "0.0001), rising again in T3 to 1.06 +/- 0.03 mmol/L. From T1 to T2, PTHi decreased from 95.4 +/- 8.7 to 66.8 8.9pg/ml), osteocalcin rose from 3.8 +/- 1.2 to 16.6 +/- 2.3ng/ml (p<0.001) and 25-Vit D rose from 16.7 +/- 1.9 to 21.4 +/- 2.1 ng/l (p<0.001), with the reversal of these changes from T2 to T3 when serum P increased once again. There was a significant correlation between serum P and PTHi and serum P and 25-Vit D. There were no significant variations of the serum Ca, Alk. Phosph., ICTP and CaFE values in the three periods.
1-Serum P never dropped below 0.55 mmol/L, which had no clinical consequences, 2- When the P dropped, PTHi also dropped and osteocalcin and 25-Vit D rose, without any major variation in bone catabolism, 3- Correction of hypophosphatemia may delay recovery from secondary hyperparathyroidism.
研究移植后低磷血症的纠正对矿物质代谢的影响。
15例肾移植术后3至12个月、血清肌酐≤177微摩尔/升的患者，因持续性低磷血症接受口服磷（P）治疗。
每隔3周进行3个阶段的血液和尿液采集。T1为口服磷基础治疗阶段，T2为停用磷、钙或磷结合剂3周后，T3为重新开始口服磷补充剂3周后。
血清磷从T1降至T2（从1.03±0.03毫摩尔/升降至0.83±0.03毫摩尔/升，p＜0.0001），在T3时再次升至1.06±0.03毫摩尔/升。从T1到T2，甲状旁腺激素免疫反应性（PTHi）从95.4±8.7降至66.8±8.9皮克/毫升，骨钙素从3.8±1.2升至16.6±2.3纳克/毫升（p＜0.001），25-维生素D从16.7±1.9升至21.4±2.1纳克/升（p＜0.001），当血清磷在T2到T3再次升高时，这些变化发生逆转。血清磷与PTHi以及血清磷与25-维生素D之间存在显著相关性。三个阶段血清钙、碱性磷酸酶、I型胶原交联羧基末端肽（ICTP）和钙排泄分数（CaFE）值无显著变化。
