MODULATION OF RENAL OSTEODYSTROPHY BY EXTRARENAL PRODUCTION OF CALCITRIOL

被引：3

作者：

DELMEZ, JA

DUSSO, AS

SLATOPOLSKY, E

TEITELBAUM, SL

机构：

[1] WASHINGTON UNIV,SCH MED,DIV RENAL,ST LOUIS,MO 63110

[2] JEWISH HOSP ST LOUIS,DEPT PATHOL,ST LOUIS,MO 63110

来源：

AMERICAN JOURNAL OF NEPHROLOGY | 1995年 / 15卷 / 01期

关键词：

PARATHYROID HORMONE; CALCITRIOL; RENAL FAILURE; OSTEODYSTROPHY;

D O I：

10.1159/000168807

中图分类号：

R5 [内科学]; R69 [泌尿科学（泌尿生殖系疾病）];

学科分类号：

1002 ; 100201 ;

摘要：

We report a patient with severe chronic renal failure who developed spontaneous bone fractures. He was found to have hypercalcemia, normal calcitriol levels (probably due to extrarenal production by noncaseating granulomas), and functional hypoparathyroidism. The bone biopsy showed low bone turnover and the presence of noncaseating granulomas. Treatment with corticosteroids decreased the calcium and calcitriol levels and the parathyroid hormone levels rose. No further fractures occurred. A repeat bone biopsy revealed the presence of osteitis fibrosa. Renal osteodystrophy may be modulated by extrarenal production of calcitriol. In this case, excessive suppression of parathyroid hormone by endogenous calcitriol presumably caused an adynamic bone lesion and spontaneous fractures.

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页码：85 / 89

页数：5

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