Sanchez CP, Goodman WG, Ramirez JA, Gales B, Belin R, Segre GV, Salusky AB
Calcium-regulated parathyroid hormone secretion in adynamic renal osteodystrophy

Kidney Int (Sep) 48:838-843 1995

The acute effects of hypocalcemic and hypercalcemia on PTH secretion was studied in 30 teenagers on peritoneal dialysis and 20 healthy volunteers. Eight of the 30 had adynamic bone and 22 had histological evidence of osteitis fibrosa. The sigmoidal curve depicting the relationship between I Ca and serum PTH (% of maximum) showed no difference in the set-point (defined as the I Ca level at which the PTH level is halfway between the maximum value during hypocalcemia and minimum value during hypercalcemia) between the three groups. The slope of the curves at the set-point was the same in the osteitis and normal groups but lower in the adynamic group suggesting an insensitivity to acute changes in calcium levels. The authors conclude that abnormalities in the set-point do not account for differences in PTH levels in adynamic and osteitis bone lesions. They speculate that the differences in PTH levels are due to the larger size of the gland in osteitis fibrosa.
Comment: A well-done study in an area with much conflicting data reflecting differences in methodology and, perhaps, severity of the hyperparathyroidism. The size of the glands was not assessed. (Delmez)

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CRF by problem area : Bone disease/aluminum