Abstract | OBJECTIVES: DESIGN AND SETTING: Prospective parallel group trial at a tertiary care centre. SUBJECTS, INTERVENTION AND MAIN OUTCOME MEASURES: Two patient cohorts (cohort 1: 14 CKD patients; cohort 2: 14 renal transplant recipients) underwent parathyroidectomy for uncontrolled secondary hyperparathyroidism. We assessed PMN iCa(2+) (primary objective) spectrofluorimetrically 1 day before and 20 days after intervention (secondary objective: PMN glucose uptake). Data were compared with those of 16 matched maintenance haemodialysis patients (cohort 3), and to 15 healthy subjects (cohort 4), by generalized estimating equations. RESULTS: PMN iCa(2+) of cohort 1 decreased over time and was significantly higher than that of cohort 3 before but not after parathyroidectomy [mean difference before/after parathyroidectomy: 19.1 nmol L(-1) (95% confidence interval: 9.4-22.4), P =0.0003/-3.2 (-20.9-14.5), P = 0.71]. PMN iCa(2+) of cohort 2 decreased over time, but we found no significant difference in comparison with cohort 3 [mean difference before/after parathyroidectomy: 6.5 nmol L(-1) (-9.4-22.4), P = 0.4/-15.8 (-43.6-12.0), P = 0.25]. PMN iCa(2+) of all CKD patients was substantially higher in comparison with that of healthy subjects [cohort 4 vs. 3: -35.3 (-48.9-21.6), P < 0.001]. PMN glucose uptake increased significantly in both interventional cohorts in comparison with cohort 3. CONCLUSIONS:
Parathyroidectomy lowers, but does not normalize PMN iCa(2+) of CKD patients. Further variables, possibly uraemic retention solutes, control both PMN iCa(2+) and functional responses.
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Authors | R Deicher, B Kirsch, M Müllner, K Kaczirek, B Niederle, W H Hörl |
Journal | Journal of internal medicine
(J Intern Med)
Vol. 258
Issue 1
Pg. 67-76
(Jul 2005)
ISSN: 0954-6820 [Print] England |
PMID | 15953134
(Publication Type: Clinical Trial, Journal Article)
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Chemical References |
- Parathyroid Hormone
- Deoxyglucose
- Calcium
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Topics |
- Adult
- Calcium
(analysis)
- Cytosol
(metabolism)
- Deoxyglucose
(metabolism)
- Female
- Humans
- Hyperparathyroidism
(etiology, surgery)
- Kidney Failure, Chronic
(complications, metabolism, surgery)
- Kidney Transplantation
(methods)
- Male
- Middle Aged
- Neutrophils
(metabolism)
- Parathyroid Hormone
(blood)
- Parathyroidectomy
(methods)
- Prospective Studies
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