Role of parathyroid hormone in the phosphaturia of extracellular fluid volume expansion

Schneider, Edward G.; Goldsmith, Ralph S.; Arnaud, Claud D.; Knox, Franklin G.
January 1975
Kidney International;Jan1975, Vol. 7 Issue 1, p317
Academic Journal
Acute expansion of the extracellular fluid volume increases the urinary excretion of phosphate. The present study examined the importance of increased plasma parathyroid hormone concentration in the phosphaturia accompanying acute extracellular fluid volume expansion (ECVE). Infusion of a calcium-free Ringer's solution into dogs was associated with increased urinary phosphate excretion and serum immunoreactive parathyroid hormone concentration (iPTH), the latter being significantly correlated with a decrease in plasma ionized calcium concentration. Prevention of the fall in plasma ionized calcium concentration by infusion of a calcium containing Ringer's solution prevented the increase in serum iPTH but the magnitude of the phosphaturia was not affected. The phosphaturia associated with ECVE was also not affected in thyroparathyroidectomized (TPTX) dogs which received a maintenance infusion of bovine PTH. In contrast, in acutely TPTX dogs which did not receive a maintenance infusion of PTH, the phosphaturic response to ECVE was significantly depressed. These data indicate that 1) the increase in serum iPTH concentration following ECVE is the result of a fall in plasma ionized calcium concentration, 2) the increase in phosphate excretion accompanying ECVE is not dependent on an increase in serum iPTH concentration and 3) in the presence of a low or falling serum PTH concentration, the increase in phosphate excretion can be significantly blunted.


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