Montenegro J, Saracho R, González O, Moina I, Martínez I
Nefrología, Hospital de Galdácano, Vizcaya, Spain.
Clin Nephrol. 1997 Dec;48(6):359-63.
The i-PTH response to changes in the peritoneal calcium balance was studied prospectively in a group of 13 stable CAPD patients, who presumably had adynamic bone disease, with low or normal i-PTH values and low aluminum in plasma. Five days after the reduction of dialysate calcium concentration from 1.75 mmol/l to 1 mmol/l, there was a significant elevation in the serum i-PTH. These increased PTH levels returned to baseline values when patients were changed to the 1.75 mmol/l Ca solution (p = 0.004). The changes in i-PTH mirrored the changes in peritoneal calcium balances. These results support the notion that the low or normal levels of i-PTH frequently seen in peritoneal dialysis patients are due to the hypercalcemic effects of the standard peritoneal dialysis solutions; in these patients, the parathyroid hormone production is normal since negative peritoneal balances of calcium are associated with an increase in serum i-PTH.
前瞻性研究了一组13例稳定的持续性非卧床腹膜透析（CAPD）患者，这些患者可能患有动力缺失性骨病，其血浆全段甲状旁腺激素（i-PTH）值低或正常，且铝含量低，以观察i-PTH对腹膜钙平衡变化的反应。在透析液钙浓度从1.75 mmol/l降至1 mmol/l 5天后，血清i-PTH显著升高。当患者改用1.75 mmol/l钙溶液时，这些升高的甲状旁腺激素水平恢复到基线值（p = 0.004）。i-PTH的变化反映了腹膜钙平衡的变化。这些结果支持以下观点：腹膜透析患者中常见的i-PTH低水平或正常水平是由于标准腹膜透析液的高钙血症作用所致；在这些患者中，甲状旁腺激素的产生是正常的，因为腹膜钙的负平衡与血清i-PTH的增加有关。
