Altered parathyroid set point to calcium in familial hypocalciuric hypercalcaemia

1984 ◽  
Vol 106 (2) ◽  
pp. 215-218 ◽  
Author(s):  
J. Auwerx ◽  
M. Demedts ◽  
R. Bouillon
Keyword(s):  
Parathyroid Hormone ◽  
Interstitial Lung Disease ◽  
Lung Disease ◽  
Linear Relationship ◽  
Calcium Concentration ◽  
Disodium Edta ◽  
Serum Parathyroid Hormone ◽  
Set Point ◽  
Serum Pth ◽  
The Right

Abstract. Changes in calcium concentration were induced by an infusion of disodium-EDTA or calcium in 2 members of a family suffering from hypocalciuric hypercalcaemia (FHH) associated with interstitial lung disease. These changes in calcium demonstrated an inverse linear relationship with the changes in serum parathyroid hormone (PTH). Infusion of EDTA in control subjects and in patients with an adenoma or hyperplasia of the parathyroid glands also showed inverse relationships between calcium and PTH. The correlation between serum calcium and serum PTH was significant over the range observed during the induced hypo- and/or hypercalcaemia in controls and in patients with FHH or adenoma. The regressions were, however, shifted relative to each other: in comparison with controls, the FHH was displaced upwards and to the right, although not as far as the adenomas. These findings suggest the existence of an elevated set point for extracellular calcium (or calciostat) in FHH.

Calcitriol therapy and calcium-regulated PTH secretion in patients with secondary hyperparathyroidism

1994 ◽  
Vol 267 (6) ◽  
pp. E961-E967 ◽  
Author(s):  
J. A. Ramirez ◽  
W. G. Goodman ◽  
T. R. Belin ◽  
B. Gales ◽  
G. V. Segre ◽  
...  
Keyword(s):  
Parathyroid Hormone ◽  
Secondary Hyperparathyroidism ◽  
Dynamic Tests ◽  
Serum Parathyroid Hormone ◽  
Maximum Increase ◽  
Set Point ◽  
Parathyroid Function ◽  
Before And After ◽  
Intermittent Calcitriol ◽  
Serum Pth

Calcitriol lowers serum parathyroid hormone (PTH) levels in patients with secondary hyperparathyroidism, but its effect on calcium-regulated PTH release remains controversial. Thus 11 patients with secondary hyperparathyroidism underwent dynamic tests of parathyroid function before and after 4 mo of intermittent calcitriol therapy. Serum calcitriol levels rose from 8 +/- 1 to 55 +/- 9 (SE) pg/ml, P < 0.01, serum total and ionized calcium levels increased, and serum PTH levels decreased from 584 +/- 154 to 154 +/- 31 pg/ml, P < 0.05. The maximum increase in serum PTH during hypocalcemia did not differ before (248 +/- 78 pg/ml) or after (280 +/- 100 pg/ml) treatment, but the increase in PTH, expressed as a percentage of preinfusion values, was greater after treatment (329 +/- 73 vs. 132 +/- 10%, P < 0.05). The decreases in serum PTH during calcium infusions did not differ before (70 +/- 5%) or after (73 +/- 5%) therapy, and the set point for PTH release did not change (1.20 +/- 0.03 vs. 1.23 +/- 0.01 mmol/l, not significant). Calcitriol modifies PTH secretion during hypocalcemia in secondary hyperparathyroidism without affecting the set point for PTH release; although calcitriol lowers serum PTH levels, it may also restore the secretory reserve of hyperplastic parathyroid tissues during hypocalcemia.

scholarly journals Low serum parathyroid hormone is a risk factor for peritonitis episodes in incident peritoneal dialysis patients: a retrospective study

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Yuqi Yang ◽  
Jingjing Da ◽  
Yi Jiang ◽  
Jing Yuan ◽  
Yan Zha
Keyword(s):  
Risk Factor ◽  
Peritoneal Dialysis ◽  
Parathyroid Hormone ◽  
Proportional Hazard ◽  
Serum Parathyroid Hormone ◽  
Cox Proportional Hazard ◽  
Cox Proportional Hazard Regression ◽  
Gram Negative Organisms ◽  
Serum Pth

Abstract Background Serum parathyroid hormone (PTH) levels have been reported to be associated with infectious mortality in peritoneal dialysis (PD) patients. Peritonitis is the most common and fatal infectious complication, resulting in technique failure, hospital admission and mortality. Whether PTH is associated with peritonitis episodes remains unclear. Methods We examined the association of PTH levels and peritonitis incidence in a 7-year cohort of 270 incident PD patients who were maintained on dialysis between January 2012 and December 2018 using Cox proportional hazard regression analyses. Patients were categorized into three groups by serum PTH levels as follows: low-PTH group, PTH < 150 pg/mL; middle-PTH group, PTH 150-300 pg/mL; high-PTH group, PTH > 300 pg/mL. Results During a median follow-up of 29.5 (interquartile range 16–49) months, the incidence rate of peritonitis was 0.10 episodes per patient-year. Gram-positive organisms were the most common causative microorganisms (36.2%), and higher percentage of Gram-negative organisms was noted in patients with low PTH levels. Low PTH levels were associated with older age, higher eGFR, higher hemoglobin, calcium levels and lower phosphate, alkaline phosphatase levels. After multivariate adjustment, lower PTH levels were identified as an independent risk factor for peritonitis episodes [hazard ratio 1.643, 95% confidence interval 1.014–2.663, P = 0.044]. Conclusions Low PTH levels are independently associated with peritonitis in incident PD patients.

The Sigmoidal Parathyroid Hormone-Ionized Calcium Curve and the Set Point of Calcium in Hemodialysis and Continuous Ambulatory Peritoneal Dialysis

1993 ◽  
Vol 13 (2_suppl) ◽  
pp. 476-479 ◽  
Author(s):  
Fabio Malberti ◽  
Bruno Corradi ◽  
Bruno Pagliari ◽  
Dino Romanini ◽  
Antonietta Gazo ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Parathyroid Hormone ◽  
Parathyroid Gland ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Ionized Calcium ◽  
Set Point ◽  
High Incidence ◽  
Adynamic Bone ◽  
The Right ◽  
Aluminum Intoxication

A high Incidence of adynamic bone disease not related to aluminum Intoxication has been reported In continuous ambulatory peritoneal dialysis (CAPD). Since reduced parathyroid hormone (PTH) secretion may predispose to adynamic bone, we Investigated whether parathyroid gland sensitivity may be depressed In CAPD in comparison with hemodialysis (HD). Thus we determined parathyraid function by the evaluation of the PTH-ionized calcium (ICa) relationship, which was obtained Inducing hypocalcemia and hypercalcemia In 19 CAPD and 18 HD patients with biochemical and histological evidence of mild (MILD) or severe (OF) hyperparathyroidism, but negative stainable bone aluminum. Either CAPD or HD patients with OF showed a shift to the right of the sigmoidal PTH-ICa curve in comparison with patients with MILD, greater set point of calcium, and maximal PTH stimulation and Inhibition. The PTH-lCa curve and the other parathyraid function parameters were not different in CAPD and HD patients within the same bone histological group. In conclusion, our data document that parathyroid gland activity Is stimulated either in CAPD and HD patients with OF, but is not depressed in CAPD patients in comparison with HD patients.

Seasonal levels of serum parathyroid hormone, calcitonin and alkaline phosphatase in relation to antler cycles in white-tailed deer

1984 ◽  
Vol 106 (2) ◽  
pp. 234-240 ◽  
Author(s):  
Chun Chin Chao ◽  
Robert D. Brown ◽  
Leonard J. Deftos
Keyword(s):  
Alkaline Phosphatase ◽  
Body Weight ◽  
Parathyroid Hormone ◽  
Feed Intake ◽  
Feed Consumption ◽  
Late Winter ◽  
Serum Parathyroid Hormone ◽  
Serum Samples ◽  
Antler Growth ◽  
Serum Pth

Abstract. Seasonal levels of serum parathyroid hormone (PTH), calcitonin (CT), and alkaline phosphatase (AP) were studied in relation to antler growth cycles in 8 male (2.5–6 years old) white-tailed deer. Feed consumption was recorded weekly, whereas body weight was recorded biweekly. Antler length was measured from the pedicle to the tip after velvet growth was initiated. Serum samples were obtained biweekly while animals were tranquilized with xylazine hydrochloride. Serum Ca was significantly (P < 0.05) elevated during the summer. Serum P was significantly (P < 0.05) elevated only during early fall. There was an increase in serum PTH during velvet initiation in April–May, but not thereafter. CT increased during the rapid antler growth period. Serum PTH levels were significantly (P < 0.05) elevated (0.628 vs 0.884 ng/ml) during post-velvet shedding and decreased (0.602 vs 0.346 ng/ml, P < 0.05) during postantler casting. Serum AP activity was highest during rapid velvet antler growth. Feed intake was lowest in early winter, but a compensatory increase was found in late winter. Feed intake peaked in May, then gradually decreased. Body weight was maximum in November and minimum in March. It is concluded that increased PTH during velvet initiation is responsible for Ca absorption and/or mobilization. Increasing PTH levels are related to final mineralization of antlers post-velvet shedding. Higher levels of serum Ca in June–July inhibit continued increase in PTH. Increased CT during rapid antler growth may have prevented excessive bone resorption.

scholarly journals Low Serum Parathyroid Hormone is a Risk Factor for Peritonitis Episodes in Incident Peritoneal Dialysis Patients: A Retrospective Study 

2020 ◽  
Author(s):  
Yuqi Yang ◽  
Jingjing Da ◽  
Yi Jiang ◽  
Jing Yuan ◽  
Yan Zha
Keyword(s):  
Risk Factor ◽  
Peritoneal Dialysis ◽  
Parathyroid Hormone ◽  
Proportional Hazard ◽  
Serum Parathyroid Hormone ◽  
Cox Proportional Hazard ◽  
Cox Proportional Hazard Regression ◽  
Serum Pth ◽  
Technique Failure

Abstract Backgroud: Serum parathyroid hormone (PTH) levels have been reported to be associated with infectious mortality in peritoneal dialysis (PD) patients. Peritonitis is the most common and fatal infectious complication, resulting in technique failure, hospital admission and mortality. Whether PTH is associated with peritonitis episodes remains unclear.Methods: We examined the association of PTH levels and peritonitis incidence in a 7-year cohort of 270 incident PD patients who were maintained on dialysis between January 2012 and December 2018 using Cox proportional hazard regression analyses. Patients were categorized into three groups by serum PTH levels as follows: low-PTH group, PTH<150pg/mL; middle-PTH group, PTH=150-300pg/mL; high-PTH group, PTH>300pg/mL .Results: During a median follow-up of 29.5 (interquartile range 16-49) months, 73 (27.0%) peritonitis episodes occurred. Low PTH levels were associated with older age, higher calcium levels and lower alkaline phosphatase levels. After multivariate adjustment, lower PTH levels were identified as an independent risk factor for peritonitis episodes [hazard ratio 1.643, 95% confidence interval 1.014-2.663, P=0.044].Conclusions: Low PTH levels are independently associated with peritonitis in incident PD patients.

scholarly journals Control of hyperparathyroidism with the intravenous calcimimetic etelcalcetide in dialysis patients adherent and non-adherent to oral calcimimetics

2020 ◽  
Author(s):  
Maria Dolores Arenas ◽  
Cristian Rodelo-Haad ◽  
M Victoria Pendón-Ruiz de Mier ◽  
Mariano Rodriguez
Keyword(s):  
Parathyroid Hormone ◽  
Standard Deviation ◽  
Secondary Hyperparathyroidism ◽  
Serum Phosphate ◽  
Dialysis Patients ◽  
Serum Parathyroid Hormone ◽  
Apparent Lack ◽  
Serum Pth ◽  
And Control ◽  
Possible Cause

Abstract Background In dialysis patients, non-adherence to oral cinacalcet adds complexity to the control of secondary hyperparathyroidism. The present study aims to evaluate the use of intravenous calcimimetic, etelcalcetide, in the control of secondary hyperparathyroidism in patients adherent and non-adherent to oral calcimimetics. Method The Simplified Medication Adherence Questionnaire was used to identify non-adherence. Almost half of the patients were non-adherent to the treatment with cinacalcet. Twenty-five patients (15 non-adherent) were switched from cinacalcet to etelcalcetide and were followed-up monthly for 8 months. Results Cinacalcet was discontinued for 1 week before the initiation of etelcalcetide. After this period, the serum PTH levels increased by2-fold in adherent patients, whereas it did not change in non-adherent patients suggesting that they were not taking the medication. Etelcalcetide progressively reduced serum parathyroid hormone (PTH) (mean ± standard deviation) from 818 ± 395 to 367 ± 289 pg/mL (P &lt; 0.001) in non-adherents, and from 496 ± 172 to 228 ± 111 pg/mL (P &lt; 0.01) in adherent patients with a mean dose of 7.0 ± 2.3 and 5.1 ± 1.2 mg in non-adherent and in adherent patients, respectively. Etelcalcetide increased the percentage of patients with PTH on target from 28% to 58%. Patients with serum calcium &lt;8.4 mg/dL increased from 8% to 40%, although they remained asymptomatic. The percent of patients with serum phosphate on target increased from 40% to 65%. Conclusion The lack of adherence to cinacalcet is a possible cause of the apparent lack of response to oral calcimimetic. The use of etelcalcetide ensures compliance and control of secondary hyperparathyroidism in both non-adherent and adherent patients.

Endovascular Treatment of Multiple Bronchial Artery Aneurysms With Prominent Fistula to Pulmonary Artery in a Patient With Interstitial Lung Disease: A Case Report and Literature Review

2019 ◽  
Vol 53 (6) ◽  
pp. 492-496
Author(s):  
Yuan Li ◽  
Guang-Chao Gu ◽  
Bao Liu ◽  
Jiang Shao ◽  
Yu Chen ◽  
...  
Keyword(s):  
Interstitial Lung Disease ◽  
Lung Disease ◽  
Bronchial Artery ◽  
Pulmonary Arteries ◽  
Artery Aneurysm ◽  
Transcatheter Embolization ◽  
Life Threatening ◽  
Nontarget Embolization ◽  
Feeding Vessels ◽  
The Right

Bronchial artery aneurysm (BAA) is a rare entity. Ruptured BAA can cause life-threatening hemorrhage. It is recommended that treatment should be initiated immediately after diagnosis. We present the case of a 56-year-old female with multiple BAAs and interstitial lung disease. Aortic computed tomography angiography demonstrated that the largest aneurysm at the right hilum was fed by right subclavian artery and right bronchial artery. A fistula between the pulmonary trunk and the aneurysm was also revealed. The patient underwent transcatheter embolization. Coils were placed in the feeding vessels instead of the aneurysms to avoid nontarget embolization of the pulmonary arteries through the fistula. The procedure achieved reduction in aneurysmal blood flow. The patient’s cough resolved at 6-month follow-up.

scholarly journals Low calcium:phosphorus ratio in habitual diets affects serum parathyroid hormone concentration and calcium metabolism in healthy women with adequate calcium intake

2009 ◽  
Vol 103 (4) ◽  
pp. 561-568 ◽  
Author(s):  
Virpi E. Kemi ◽  
Merja U. M. Kärkkäinen ◽  
Hannu J. Rita ◽  
Marika M. L. Laaksonen ◽  
Terhi A. Outila ◽  
...  
Keyword(s):  
Parathyroid Hormone ◽  
Molar Ratio ◽  
Food Record ◽  
Serum Parathyroid Hormone ◽  
Cross Sectional ◽  
Healthy Women ◽  
Serum Pth ◽  
Sectional Analysis ◽  
Ca:P Ratio ◽  
Recommended Level

Excessive dietary P intake alone can be deleterious to bone through increased parathyroid hormone (PTH) secretion, but adverse effects on bone increase when dietary Ca intake is low. In many countries, P intake is abundant, whereas Ca intake fails to meet recommendations; an optimal dietary Ca:P ratio is therefore difficult to achieve. Our objective was to investigate how habitual dietary Ca:P ratio affects serum PTH (S-PTH) concentration and other Ca metabolism markers in a population with generally adequate Ca intake. In this cross-sectional analysis of 147 healthy women aged 31–43 years, fasting blood samples and three separate 24-h urinary samples were collected. Participants kept a 4-d food record and were divided into quartiles according to their dietary Ca:P ratios. The 1st quartile with Ca:P molar ratio ≤ 0·50 differed significantly from the 2nd (Ca:P molar ratio 0·51–0·57), 3rd (Ca:P molar ratio 0·58–0·64) and 4th (Ca:P molar ratio ≥ 0·65) quartiles by interfering with Ca metabolism. In the 1st quartile, mean S-PTH concentration (P = 0·021) and mean urinary Ca (U-Ca) excretion were higher (P = 0·051) than in all other quartiles. These findings suggest that in habitual diets low Ca:P ratios may interfere with homoeostasis of Ca metabolism and increase bone resorption, as indicated by higher S-PTH and U-Ca levels. Because low habitual dietary Ca:P ratios are common in Western diets, more attention should be focused on decreasing excessively high dietary P intake and increasing Ca intake to the recommended level.

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