Wibell L, Dahlberg P A, Karlsson A
Acta Med Scand. 1979;206(6):507-10. doi: 10.1111/j.0954-6820.1979.tb13555.x.
The urinary output of beta 2-microglobulin was measured in ten hypercalcemic patients undergoing surgery because of hyperparathyroidism. In three subjects the beta 2-microglobulin excretion was abnormally increased and in seven patients it was normal before surgery. Three of these seven patients displayed markedly impaired distal tubular function with a reduced urinary concentration capacity. After surgery all patients became normocalcemic and the urinary concentrating capacities improved. The beta 2-microglobulin excretion, on the other hand, remained unchanged. Thus, hypercalcemia per se does not readily affect the proximal tubular function of reabsorbing low molecular weight proteins. "Tubular proteinuria", if found in patients with hypercalcemia, should be suspected to reflect damage to the kidney by additional mechanisms.
对十名因甲状旁腺功能亢进接受手术的高钙血症患者测量了β2-微球蛋白的尿量。三名受试者术前β2-微球蛋白排泄异常增加，七名患者术前排泄正常。这七名患者中有三名表现出明显受损的远端肾小管功能，尿浓缩能力降低。术后所有患者血钙恢复正常，尿浓缩能力改善。另一方面，β2-微球蛋白排泄保持不变。因此，高钙血症本身不易影响近端肾小管重吸收低分子量蛋白质的功能。如果在高钙血症患者中发现“肾小管蛋白尿”，应怀疑是由其他机制导致的肾脏损伤。
