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Immunoreaktives Parathormon, 25-Hydroxycalciferol und Knochenhistologie bei renaler Osteopathie

Immunoreactive parathyroid hormone, 25-hydroxycalciferol and bone histology in renal osteodystrophy

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Summary

Immunoreactive parathyroid hormone (iPTH) and 25-hydroxycalciferol (25(OH)D) serum levels were determined in 32 patients with renal osteopathy, they were correlated with the results of bone biopsy and other clinical parameters. iPTH was closely related to bone histology, it did not correspond to serum calcium and alkaline phosphatase, but the correlation to serum phosphate was statistically significant. 25(OH)D levels were not related to the histological findings of osteomalacia or increased bone resorption, while a correlation between the vitamin D metabolite and serum calcium could be observed. Since iPTH and 25(OH)D levels exhibited a significant correlation, an inhibitory effect of 25(OH)D on parathyroid gland function in renal failure was discussed.

Zusammenfassung

Bei 32 Patienten mit renaler Osteopathie wurden die Serumspiegel des immunoreaktiven Parathormons (iPTH) und des 25-Hydroxycalciferol (25(OH)D) bestimmt und mit den Ergebnissen der Knochenbiopsie und anderen klinischen Parametern korreliert. Das iPTH entsprach den Ergebnissen der Knochenhistologie, zeigte jedoch keine Beziehung zum Serumcalcium und der alkalischen Phosphatase, während eine statistisch signifikante Korrelation mit dem Serumphosphat bestand. Die 25(OH)D-Spiegel verhielten sich unabhängig vom histologischen Nachweis einer Osteomalazie oder vermehrter Knochenresorption, es fand sich eine Beziehung zwischen dem Vitamin-D-Metaboliten und dem Serumcalcium. Da die iPTH- und die 25(OH)D-Spiegel eine signifikante inverse Korrelation zeigten, wurde ein inhibitorischer Effekt des 25(OH)D auf die Nebenschilddrüsenfunktion bei Niereninsuffizienz diskutiert.

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Literatur

  1. Arnaud, C.D., Tsao, H.S., Littledike, T.: Radioimmunoassay of human parathyroid hormone in serum. J. clin. Invest.50, 21 (1971)

    PubMed  Google Scholar 

  2. Arnaud, C.D.: Hyperparathyroidism an renal failure. Kidney int.4, 89 (1973)

    PubMed  Google Scholar 

  3. Arnaud, C.D., Goldsmith, R.S., Bordier, P.J., Sizemore, G.W.: Influence of immunoheterogeneity of circulating parathyroid hormone on results of radioimmunoassays of serum in man. Amer. J. Med.56, 785 (1974)

    PubMed  Google Scholar 

  4. Bayard, F., Bec, P., Ton That, H., Louvet, J.P.: Plasma 25-hydroxycholecalciferol in chronic renal failure. Europ. J. clin. Invest.3, 447 (1973)

    PubMed  Google Scholar 

  5. Bricker, N.S.: On the pathogenesis of the uremic state: an exposition of the “trade-off-hypothesis”. New Engl. J. Med.286, 1093 (1972)

    PubMed  Google Scholar 

  6. Brumbaugh, P.F., Haussler, D.H., Bressler, R., Haussler, M.R.: Radioreceptor assay for 1α, 25-dihydroxyvitamin D3. Science183, 1089 (1974)

    PubMed  Google Scholar 

  7. Canterbury, J.M., Reiss, E.: Multiple immunoreactive molecular forms of parathyroid hormone in human serum. Proc. Soc. exp. Biol.140, 1393 (1972)

    Google Scholar 

  8. Delling, G.: Über eine vereinfachte Methacrylateinbettung für unentkalkte Knochenschnitte. Beitr. path. Anat.145, 100 (1972)

    Google Scholar 

  9. Delling, G.: Age related bone changes. Curr. Top. Path.58, 117 (1973)

    Google Scholar 

  10. Delling, G., Schulz, A., Schulz, W.: Klassifikation der renalen Osteopathie. Nephrol. Arbeitstagung, Köln 1974, Melsunger med. Mitteilung49, Suppl. I, 133 (1975)

    Google Scholar 

  11. Delling, G.: Endokrine Osteopathien. Veröffentl. Path.98, Fischer Verlag, Stuttgart 1975

    Google Scholar 

  12. DeLuca, H.F.: The kidney as an endocrine organ involved in calcium homeostasis. Kidney int.4, 80 (1973)

    PubMed  Google Scholar 

  13. Fischer, J.A., Binswanger, U., Fanconi, A., Illig, R., Baerlocher, K., Prader, A.: Serum parathyroid hormone concentrations in vitamin D deficiency rickets of infancy: effects of intravenous calcium and vitamin D. Horm. Metab. Res.5, 381 (1973)

    PubMed  Google Scholar 

  14. Fischer, J.A., Blum, J.W., Binswanger, U.: Acute parathyroid hormone response to epinephrine in vivo. J. clin. Invest.52, 2434 (1973)

    PubMed  Google Scholar 

  15. Fraser, D.R., Kodicek, E.: Unique biosynthesis by kidney of a biologically active vitamin D metabolite. Nature (Lond.)228, 764 (1970)

    Google Scholar 

  16. Frolik, C.A., DeLuca, H.F.: 1,25-dihydroxycholecalciferol: the metabolite of vitamin D responsible for increased intestinal calcium transport. Arch. Biochem.147, 143 (1971)

    PubMed  Google Scholar 

  17. Gray, R., Boyle, I., DeLuca, H.F.: Vitamin D metabolism: the role of kidney tissue. Science172, 1232 (1971)

    PubMed  Google Scholar 

  18. Haddad, J.G., Chyu, K.J.: Competitive protein-binding radioassay for 25-hydroxycholecalciferol J. clin. Endocr.33, 992, (1971

    Google Scholar 

  19. Haddad, J.G., Hahn, T.J.: Natural and synthetic sources of circulating 25-hydroxyvitamin D in man. Nature244, 515 (1973)

    Google Scholar 

  20. Haddad, J.G., Stamp, T.C.B.: Circulating 25-hydroxyvitamin D in man. Amer. J. Med.57, 57 (1974)

    PubMed  Google Scholar 

  21. Haussler, M.R., Brumbaugh, P.F., Ogden, D.A.: Radioreceptor assay of plasma 1,25-dihydroxy-vitamin D3 in patients with chronic renal failure. Clin. Res.22, 531A (1974)

  22. Holick, M.F., Garabedian, M., DeLuca, H.F.: 1,25-dihydroxycholecalciferol: metabolite of vitamin D3 active on bone in anephric rats. Science176, 1146 (1972)

    PubMed  Google Scholar 

  23. Kodicek, E., Lawson, D.E.M., Wilson, P.W.: Biological activity of a polar metabolite of vitamin D3. Nature (Lond.)228, 763 (1970)

    Google Scholar 

  24. Letteri, J., Roginsky, M., Moo, F., Cohn, S.: Plasma 25-hydroxycalciferol (25-OHC) in chronic renal failure. Clin. Res.22, 474A (1974)

  25. Lumb, G.A., Stanbury, S.W.: Parathyroid function in human vitamin D deficiency and vitamin D deficiency in primary hyperparathyroidism. Amer. J. Med.56, 833 (1974)

    PubMed  Google Scholar 

  26. Malluche, H., Ritz, E., Hodgson, M., Gati, A., Krause, W., Lange, H.P.: Skeletal lesions and calcium metabolism in early renal failure. Kidney int.6, 11a (1974)

  27. Massry, S.G.: Divalent ions in renal failure. Introduction. Kidney int.4, 71 (1973)

    PubMed  Google Scholar 

  28. Massry, S.G., Coburn, J.W., Lee, D.B.N., Jowsey, J., Kleemann, C.R.: Skeletal resistance to parathyroid hormone in renal failure: study in 105 human subjects. Ann. Intern. Med.78, 357 (1973)

    PubMed  Google Scholar 

  29. Mawer, E.B., Backhouse, J., Taylor, C.M., Lumb, G.A., Stanbury, S.W.: Failure of formation of 1,25-dihydroxycholecalciferol in chronic renal insufficiency. Lancet1, 626 (1973)

    PubMed  Google Scholar 

  30. Norman, A.W., Midgett, R.J., Myrtle, J.F., Nowicki, H.G.: Studies on calciferol metabolism: I. Production of vitamin D metabolite 4B from 25-OH-cholecalciferol by kidney homogenates. Biochem. biophys. Res. Commun.42, 1082 (1971)

    PubMed  Google Scholar 

  31. Norman, A.W., Myrtle, J.F., Midgett, R.J., Nowicki, H.G.: 1,25-dihydroxycholecalciferol: identification of the proposed active form of vitamin D3 in the intestine. Science173, 51 (1971)

    PubMed  Google Scholar 

  32. Offermann, G.: Methoden und Ergebnisse der 25-OH-Vitamin-D3-Bestimmung im kompetitiven Proteinbindungsassay. Münch. med. Wschr.116, 1569 (1974)

    Google Scholar 

  33. Offermann, G., von Herrath, D., Schaefer, K.: 25-Hydroxycholecalciferol in uremia. Nephron13, 269 (1974)

    PubMed  Google Scholar 

  34. Offermann, G., Opitz, A., Sörensen, R.: Lokalisation der Nebenschilddrüsenadenome bei primärem Hyperparathyreoidismus durch selektive Parathormonbestimmung. Dtsch. med. Wschr.99, 1308 (1974)

    PubMed  Google Scholar 

  35. Offermann, G., Schaefer, K.: Neue Ergebnisse der Vitamin D-Forschung. Teil 1. Med. Mschr.28, 374 (1974)

    Google Scholar 

  36. Offermann, G., Schaefer, K.: Neue Ergebnisse der Vitamin D-Forschung. Teil 2. Med. Mschr.28, 447 (1974)

    Google Scholar 

  37. Offermann, G., Dittmar, F.: Applications of the 25(OH)D assay in diagnosis and treatment of azotemic bone disease. In: Vitamin D and problems related to uremic bone disease Verlag Walter de Gruyter, Berlin, New York 1975, p. 295 Hrsg.: Norman, A.W., Schaefer, K., Grigoleit, H.G., v. Herrath, D., Ritz, E.

  38. Oldham, S.B., Arnaud, C.D., Jowsey, J.: Influence of vitamin D on canine parathyroid glands (PTG's) (Abstract). Clin. Res.21, 254 (1973)

    Google Scholar 

  39. Raisz, L.G., Trummel, C.L., Holick, M.F., DeLuca, H.F.: 1,25-dihydroxycholecalciferol: a potent stimulator of bone resorption in tissue culture. Science175, 768 (1972)

    PubMed  Google Scholar 

  40. Rasmussen, H.: The relationship between parathyroid hormone and vitamin D In: Clinical aspects of metabolic bone disease. Ed.: Frame, B., Parfitt, A.M., Duncan, H.: Excerpta Medica, Amsterdam 1973, p. 634

    Google Scholar 

  41. Reiss, E., Canterbury, J.M., Egdahl, R.H.: Experience with a radioimmunoassay of parathyroid hormone in human sera. Trans. Ass. Amer. Phycns.81, 104 (1968)

    Google Scholar 

  42. Reiss, E., Canterbury, J.M., Bercovitz, M.A., Kaplan, E.L.: The role of phosphate in the secretion of parathyroid hormone in man. J. clin. Invest.49, 2146 (1970)

    PubMed  Google Scholar 

  43. Reiss, E., Canterbury, J.M.: Genesis of hyperparathyroidism. Amer. J. Med.50, 679 (1971)

    PubMed  Google Scholar 

  44. Ritz, E., Krempien, B., Mehls, O., Bommer, J.: Dialysis bone disease. In: Frame, B., Parfitt, A.M., Duncan, H. (ed.): Clinical aspects of metabolic bone disease. Excerpta Medica, Amsterdam 1973, p. 616

    Google Scholar 

  45. Ritz, E., Krempien, B., Mehls, O., Malluche, H.: Skeletal abnormalities in chronic renal insufficiency before and during maintenance hemodialysis. Kidney int.4, 116 (1973)

    PubMed  Google Scholar 

  46. Schaefer, K., von Herrath, D., Stratz, R.: Metabolism of 1,2 H3-4-C14-cholecalciferol in normal, uremic, and anephric subjects. Israel J. med. Sci.8, 80 (1972)

    PubMed  Google Scholar 

  47. Schenk, R.K., Olah, A.J., Merz, W.A.: Bone cell counts. In: Clinical aspects of metabolic bone disease. Ed.: Frame, B., Parfitt, A.M., Duncan, H. Excerpta Medica, Amsterdam 1973, p. 103

    Google Scholar 

  48. Schulz, W., Delling, G., Schulz, A., Heidler, R., Gessler, U.: Vergleichende klinische und histomorphometrische Untersuchungen zum Ausmaß und zur Entwicklung der renalen Osteopathie. Nieren- und Hochdruckkrankheiten3, 169 (1974)

    Google Scholar 

  49. Schulz, W., Heidler, R., Gessler, U., Nordmeyer, W., Schulz, A., Delling, G.: Vitamin D therapy in renal osteopathy of different types. In: Vitamin D and problems related to uremic bone disease. Verlag Walter de Gruyter, Berlin, New York 1975, p. 635 Hrsg.: Norman, A.W., Schaefer, K., Grigoleit, H.G., v. Herrath, D., Ritz, E.

  50. Shen, F.H., Baylink, D., Sherrard, D.: Serum 25-hydroxycholecalciferol (25-OHD) in patients with uremic bone disease (UBD). Clin. Res.21, 204 (1973)

    Google Scholar 

  51. Shen, F.H., Shen, L.H., Baylink, D.J., Sherrard, D.J.: Serum 25-OHD and PTH in uremic bone disease (UBD). Clin. Res.22, 167A (1974)

  52. Slatopolsky, E., Gradowska, L., Kashemsant, C., Keltner, R., Manley, C., Bricker, N.S.: The control of phosphate excretion in uremia. J. clin. Invest.45, 672 (1966)

    PubMed  Google Scholar 

  53. Slatopolsky, E., Robson, A.M., Elkan, I., Bricker, N.S.: Control of phosphate excretion in uremic man. J. clin. Invest.47, 1865 (1968)

    PubMed  Google Scholar 

  54. Slatopolsky, E., Caglar, S., Pennell, J.P., Taggart, D.D., Canterbury, J.M., Reiss, E., Bricker, N.S.: On the pathogenesis of hyperparathyroidism in chronic experimental renal insufficiency in the dog. J. clin. Invest.50, 492 (1971)

    PubMed  Google Scholar 

  55. Slatopolsky, E., Bricker, N.S.: The role of phosphorus restriction in the prevention of secondary hyperparathyroidism in chronic renal disease. Kidney int.4, 141 (1973)

    PubMed  Google Scholar 

  56. Stanbury, S.W.: Azotemic renal osteodystrophy, Brit. med. Bull.13, 57 (1957)

    PubMed  Google Scholar 

  57. Tanaka, Y., DeLuca, H.F., Omdahl, J., Holick, M.F.: Mechanism of action of 1,25-dihydroxycholecalciferol on intestinal calcium transport. Proc. nat. Acad. Sci. (Wash.)68, 1286 (1971)

    PubMed  Google Scholar 

  58. Tanaka, Y., Frank, H., DeLuca, H.F.: Biological activity of 1,25-dihydroxyvitamin D3 in the rat. Endocrinology92, 417 (1973)

    PubMed  Google Scholar 

  59. Verberckmoes, R., Bouillon, R.: Influence of vitamin D treatment on serum levels of parathyroid hormone fragments in patients with chronic renal failure. In: Vitamin D and problems related to uremic bone disease. Verlag Walter de Gruyter, Berlin, New York 1975, p. 629 Hrsg.: Norman, A.W., Schaefer, K., Grigoleit, H.G., v. Herrath, D., Ritz, E.

  60. Wong, R.C., Norman, A.W., Reddy, C.R., Coburn, J.W.: Biologic effects of 1,25-dihydroxycholecalciferol (a highly active vitamin D metabolite) in acutely uremic rats. J. clin. Invest51, 1287 (1972)

    PubMed  Google Scholar 

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Authors and Affiliations

  1. Medizinische Klinik und Poliklinik, Klinikum Steglitz der Freien Universität Berlin, Germany

    G. Offermann & K. Schaefer

  2. Pathologisches Institut der Universität Hamburg, Germany

    A. Schulz & G. Delling

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  1. G. Offermann
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  2. K. Schaefer
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  3. A. Schulz
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  4. G. Delling
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Mit Unterstützung der Deutschen Forschungsgemeinschaft1 und des SFB 34 „Endokrinologie“ (Hamburg) der Deutschen Forschungsgemeinschaft2

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Offermann, G., Schaefer, K., Schulz, A. et al. Immunoreaktives Parathormon, 25-Hydroxycalciferol und Knochenhistologie bei renaler Osteopathie. Klin Wochenschr 54, 625–632 (1976). https://doi.org/10.1007/BF01469028

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