Goldstein D A, Oda Y, Kurokawa K, Massry S G
Ann Intern Med. 1977 Dec;87(6):664-7. doi: 10.7326/0003-4819-87-6-664.
The blood levels of 25-hydroxyvitamin D (25-HCC) in 26 patients with nephrotic syndrome (proteinuria of 6.5 g/24 h +/- 0.8 SEM) ranged between 1 and 18.6 ng/ml (8.6 +/- 1.0 SEM). This value was significantly lower (P less than 0.01) than that in normal subjects (21.8 +/- 2.3 ng/ml) and patients with chronic renal failure (24.8 +/- 2.3 ng/ml). There was inverse correlation (P less than 0.01) between levels of 25-HCC and magnitude of proteinuria and a direct relation (P less than 0.01) with serum albumin. Reduction in proteinuria was rapidly followed by a rise in blood 25-HCC toward normal. Ionized calcium levels were low in 16 of 26 nephrotic patients irrespective of degree of renal failure. In four of seven nephrotic patients with normal renal function, ionized calcium levels were low and showed an inverse relation with levels of parathyroid hormone. These data show that patients with nephrotic syndrome have low blood levels of 25-HCC probably due to its loss in urine. This derangement is probably responsible for the disorders of calcium metabolism in nephrosis.
26例肾病综合征患者（蛋白尿6.5g/24小时±0.8标准误）的血25-羟维生素D（25-HCC）水平在1至18.6ng/ml之间（8.6±1.0标准误）。该值显著低于正常受试者（21.8±2.3ng/ml）和慢性肾衰竭患者（24.8±2.3ng/ml）（P<0.01）。25-HCC水平与蛋白尿程度呈负相关（P<0.01），与血清白蛋白呈正相关（P<0.01）。蛋白尿减少后，血25-HCC迅速上升至正常水平。26例肾病患者中有16例离子钙水平低，与肾衰竭程度无关。7例肾功能正常的肾病患者中有4例离子钙水平低，且与甲状旁腺激素水平呈负相关。这些数据表明，肾病综合征患者血25-HCC水平低可能是由于其经尿液丢失。这种紊乱可能是肾病中钙代谢紊乱的原因。
