Abstract
Patients with primary or secondary hyperparathyroidism may display abnormalities in acid-base homeostasis and in renal handling of bicarbonate. Many investigators have observed mild acidosis, low levels of serum bicarbonate and impaired urinary acidification in patients with primary hyperparathyroidism (1–6) and in those with osteomalacia or malabsorption and secondary hyperparathyroidism (7–10). Successful treatment of the state of hyperparathyroidism is usually associated with reversal of these abnormalities. On the other hand, elevated levels of serum bicarbonate were noted in patients with hypercalcemia which was not due to excess parathyroid hormone and in patients with hypoparathyroidism (2,11–14). Also, Barzel reported that mild metabolic alkalosis may be present in patients with parathyroid hormone deficiency (13, 14).
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
References
Lafferty, F.W.: Pseudohyperparathyroidism. Medicine, 45:247, 1965.
Wills, M.R., McGowan, G.K.: Plasma chloride levels in hyperparathyroidism and other hypercalcemia states. Brit. Med. J. 1:1153, 1964.
Dolman, M., Barzel, U.: Primary hyperparathyroidism: Diagnosis and treatment. New York State J. Med. 71:1201, 1971.
Mallette, L.E., Bilezikian, J.P., Heath, D.A., and Aurbach, G.D.: Primary hyperparathyroidism: Clinical and biochemical features. Medicine, 53:127, 1974.
Wrong, O., Davies, H.E.F.: The excretion of acid in renal disease. Quart. J. Med. 28:259, 1959.
Fourman, P., McConkey, B., and Smith, J.W.G.: Defects of water reabsorption and of hydrogen-ion excretion by the renal tubules in hyperparathyroidism. Lancet 1:619, 1960.
Muldowney, F.P., Freaney, R., and McGreeney, D.: Renal tubular acidosis and amino-aciduria in osteomalacia of dietary and intestinal origin. Quart. J. Med. 37:517, 1968.
York, S.E., and Yendt, E.R.: Osteomalacia associated with renal bicarbonate loss. Cand. Med. Assoc. J. 94:1329, 1966.
Muldowney, F.P., Freaney, R., and Brennan, F.: A case of osteomalacia in renal tubular acidosis associated with occult idiopathic steatorrhea: The effect of vitamin D on renal tubular hydrogen ion transport. Irish H. Med. Sci. 6:435, 1965.
Muldowney, F.P., Donohoe, J.F., Freaney, R., Kampff, C., and Swan, M.: Parathormone-induced renal bicarbonate wastage in intestinal malabsorption and in chronic renal failure. Irish J. Med. Sci. 3:221, 1970.
Thomas, W.C., Jr., Connor, T.B., and Morgan, G.: Some observations on patients with hypercalcemia examplifying problems in differential diagnosis, especially in hyperparathyroidism. J. Lab. Clin. Med. 52:11, 1958.
Heinemann, H.O.: Metabolic alkalosis in patients with hypercalcemia. Metabolism 14:1137, 1967.
Barzel, U.S.: Systemic alkalosis in hypoparathyroidism. J. Clin. Endocrinol. Metab. 29:17, 1969.
Barzel, U.S.: Parathyroid hormone, blood phosphorus, and acid-base metabolism. Lancet 1:1329, 1971.
Coe, F.L.: Magnitude of metabolic acidosis in primary hyperparathyroidism. Arch. Inter. Med. 134:262, 1974.
Muldowney, F.P., Carroll, D.V., Donohoe, J.F., and Freaney, R.: Correction of renal bicarbonate wasting by parathyroidectomy. Quart. J. Med. 40:487, 1971.
Ellsworth, R., Nicholson, W.M.: Further observations upon changes in the electrolytes of urine following the injection of parathyroid extract. J. Clin. Invest. 14:823, 1955.
Kleeman, C.R., and Cooke, R.R.E.: The acute effects of parathyroid hormone on the metabolism of endogenous phosphate. J. Lab. Clin. Med. 38:112, 1951.
Nordin, B.E.C.: The effect of intravenous parathyroid extract on urinary pH, bicarbonate and electrolyte excretion. Clin. Sci. 19:311, 1960.
Hellman, D.E., Au, W.Y.W., and Bartter, F.C.: Evidence for a direct effect of parathyroid hormone on urinary acidification. Amer. J. Physiol. 209:643, 1965.
Karlinsky, M.L., Sager, D.S., Kurtzman, N.A., and Pillay, V.K.: Effect of parathormone and cyclic adenosine monophosphate on renal bicarbonate reabsorption. Amer. J. Physiol. 227:1226.
Crumb, C.K., Martinez-Maldonado, M., Eknoyan, G., and Suki, W.N.: Effects of volume expansion, purified parathyroid extract, and calcium on renal bicarbonate absorption in the dog. J. Clin. Invest. 54:1287, 1974.
Gold, L.W., Massry, S.G., Arieff, A.I., and Coburn, J.W.: Renal bicarbonate wasting during phosphate depletion. A possible cause of altered acid-base homeostasis in hyperparathyroidism. J. Clin. Invest. 52:2556, 1973.
Stoerk, H.C., and Carnes, W.H.: The relation of the dietary Ca: P ratio to serum calcium and to parathyroid volume. J. Nutr. 29:43, 1945.
Puschett, J.B., and Fernandez, P.C.: Relationship between serum phosphate concentration and proximal tubular bicarbonate transport. Nephron, 1977 (in press).
Kurokawa, K., and Rasmussen, H.: Ionic control of renal gluconeogenesis: The interrelated effect of calcium and hydrogen ions. Biochem. Biophys. Acta. 313:17, 1973.
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 1977 Springer Science+Business Media New York
About this chapter
Cite this chapter
Massry, S.G. (1977). Metabolic Acidosis in Hyperparathyroidism Role of Phosphate Depletion and Other Factors. In: Massry, S.G., Ritz, E. (eds) Phosphate Metabolism. Advances in Experimental Medicine and Biology, vol 81. Springer, New York, NY. https://doi.org/10.1007/978-1-4613-4217-5_29
Download citation
DOI: https://doi.org/10.1007/978-1-4613-4217-5_29
Published:
Publisher Name: Springer, New York, NY
Print ISBN: 978-1-4613-4219-9
Online ISBN: 978-1-4613-4217-5
eBook Packages: Springer Book Archive