Ermakova I P, Buzulina V P, Pronchenko I A, Ermolenko A E, Il'nitskiĭ V V
Urol Nefrol (Mosk). 1993 Jul-Aug(4):39-43.
Total plasma calcium (Ca), Ca renal reabsorption, Ca tissue transport, parathyroid hormones and calcitonin were measured in fasting 30 recipients of a renal allotransplant, 95 healthy subjects, 9 primary hyperparathyroidism patients, 12 patients with bronchial asthma and exogenic hypercorticism. Total Ca proved normal in 26 but lowered in 4 recipients. Canalicular Ca reabsorption got enhanced in 17 recipients with high parathormone levels in 10 of them. Normal Ca reabsorption was registered in 13 recipients through parathormone elevated in 6 of them. Tissue Ca binding enhanced in its high reabsorption in the transplant. The binding did not depend either on parathormone secretion intensity or cyclosporin A treatment, being partially determined by steroid therapy. When investigated under Ca intravenous drop infusion in 20 recipients and 14 healthy subjects, Ca tissue binding confirmed its physiochemical nature and revealed in one third of the recipients impaired buffer capacity of the tissues as well as Ca retention and release rates. The impairment was related neither to changes in the basal level nor with secretion fluctuations of parathormone and calcitonin. Increased tissue Ca binding accounts for the absence of hypercalcemia in renal transplantation.
对30例肾移植受者、95名健康受试者、9例原发性甲状旁腺功能亢进患者、12例支气管哮喘合并外源性皮质醇增多症患者在空腹状态下测定了总血浆钙（Ca）、钙的肾重吸收、钙的组织转运、甲状旁腺激素和降钙素。结果显示，26例肾移植受者的总钙水平正常，4例降低。17例肾移植受者的肾小管钙重吸收增强，其中10例甲状旁腺激素水平升高。13例肾移植受者的钙重吸收正常，其中6例甲状旁腺激素升高。移植组织中钙重吸收增加时，组织钙结合增强。这种结合既不依赖于甲状旁腺激素的分泌强度，也不依赖于环孢素A治疗，部分由类固醇治疗决定。对20例肾移植受者和14名健康受试者进行静脉滴注钙剂研究时，钙的组织结合证实了其物理化学性质，并在三分之一的受者中发现组织缓冲能力受损以及钙的保留和释放速率异常。这种异常既与基础水平的变化无关，也与甲状旁腺激素和降钙素的分泌波动无关。组织钙结合增加解释了肾移植中无高钙血症的原因。
