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SERUM CALCIUM AND SERUM PHOSPHORUS IN URAEMIA DURING ADMINISTRATION OF SODIUM PHYTATE AND ALUMINIUM HYDROXIDE

1968; Wiley; Volume: 183; Issue: 1-6 Linguagem: Inglês

10.1111/j.0954-6820.1968.tb10513.x

0001-6101

Th. Friis, Steffen Hahnemann, Eva Weeke,

Genetic Syndromes and Imprinting

Abstract Serum calcium, serum phosphorus, urinary calcium, the percental tubular re‐absorption of phosphorus (TRP%), and the phosphate excretion index (PEI) were studied in 15 patients with uraemia and in ten normal persons. With increasing degrees of uraemia the authors found a decreasing serum calcium, a rising serum phosphorus, a decreasing urinary calcium and TRP% as well as a rising PEI. It should be emphasized that patients with very slight renal failure (creatinine clearance >40 ml/min) showed significantly lower serum phosphorus levels than did the control group, that the serum calcium fell before the serum phosphorus rose as compared with the control group when the renal failure increased, that the urinary calcium fell even in very mild renal failure, while the TRP% and PEI did not alter until the creatinine clearance fell below 40 ml/min. For the purpose of ascertaining whether the reduction of serum calcium in uraemia is due to a reduced sensitivity to the parathyroid hormone in respect of the absorption of bone or to a possible latent hypoparathyroidism in the presence of a normal serum calcium, the sodium phytate test was used (binding of calcium in the intestine). Furthermore, aluminium hydroxide was administered (binding of phosphorus in the intestinal tract) for the purpose of elucidating whether the reduced serum calcium was due to an increased serum level of phosphorus. The sodium phytate test did not give evidence of a latent hypoparathyroidism or an altered sensitivity of the bones to the parathyroid hormone. Administration of aluminium hydroxide revealed that serum calcium, when reduced, rose to almost normal values, while at the same time serum phosphorus fell. This indicates that the reduced serum calcium is due, partially at least, to the elevated serum phosphorus in these patients. It was also demonstrated that even patients with mild uraemia having a normal serum phosphorus exhibited a greater fall of serum phosphorus than normal patients during the administration of aluminium hydroxide. This indicates a reduced renal ability to preserve phosphate.