Abstract
Infrequently, the kidney may be involved in the etiology of hypercalcemia as might occur in diuretic-induced hypercalcemia (1) or the hypercalcemia of adrenal insufficiency (2), in which hypocalciuria and sodium and water diuresis may play a role. In these circumstances, the kidney may be considered the culprit in hypercalcemia. More often, however, the kidney is the victim of hypercalcemia suffering a number of derangements in hemodynamics and tubular function. The focus of this review shall be on the derangements in the structure and function of the kidney in hypercalcemic states. The spectrum of disorders of renal function and structure in hypercalcemia is summarized in Table 1. It is evident that a wide-range of renal derangements is observed in hypercalcemia. Consequently, only a few of these derangements will be the subject of a more detailed discussion.
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References
W.N. Suki, Effects of diuretics on calcium metabolism. Min. Elect. Metab., 2:125 (1979).
M. Walser, B.H. B. Robinson, and J.W. Duckett Jr., The hypercalcemia of adrenal insufficiency, J. Clin. Invest., 42:456 (1963).
C.A. Edvall, Renal function in hyperparathyroidism. A clinical study of 30 cases with special reference to selective renal clearance and renal vein catheterization. Acta Chir. Scand., 229(Suppl):l (1958).
H.D. Humes, I. Ichikawa, J.L. Troy, and B.M. Brenner, Evidence for a parathyroid hormone-dependent influence of calcium on the glomerular filtration, J. Clin. Invest., 61:32 (1978).
G. Fulgraff, G. Heinz, E. Sparwald, and O. Heidenreich, Die Wirkung von Calcium auf die Renale Ausscheidung von Kalium und Wasser und auf den renalen Solutengradienten beim Hund, Naunyn- Schmiedebergs, Arch, Pharmak. u. exp. Path., 261:299 (1968).
B.R. Edwards, R.A.L. Sutton, and J.H. Dirks, Effect of calcium infusion on renal tubular reabsorption in the dog. Am. J. Physiol. 227:13 (1974).
G.F. DiBona, Effect of hypercalcemia on renal tubular sodium handling in the rat. Am. J. Physiol. 220:49, 1971.
W.N. Suki, G. Eknoyan, F.C. Rector Jr., and D.W. Seldin, The renal diluting and concentrating mechanism in hypercalcemia. Nephron, 6:50 (1969).
J-P. Guignard, N.F. Jones, and M.A. Barraclough, Effect of brief hypercalcaemia on free water reabsorption during solute diuresis: Evidence for impairment of sodium transport in Henle’s loop, Clin. Sci., 39:337 (1970).
V. Guttman, and C.W. Gottschalk, Micropuncture study of the effect of calcium on sodium transport in the rat kidney, Israel J. Med. Sci., 2:243 (1966).
M. Baum, and S.R. Hayes, Phorbol myristate acetate and dioctanoylglycerol inhibit transport in rabbit proximal convoluted tubule. Am. J. Physiol., 254:F9 (1988).
F.H. Epstein, and R. Whitham, The mode of inhibition by calcium of cell-membrane adenosine-triphosphatase activity, Biochem. J., 99:232 (1966).
J.F. Zilva, and J.P. Nicholson, Plasma phosphate and potassium levels in the hypercalcemia of malignant disease, J. Clin. Endocrinol. Metab., 36:1019 (1973).
G.S. Brinton, W. Jubiz, L.D. Lagerqiust, Hypertension in primary hyperparathyroidism: The role of the renin-angiotensin system, J. Clin. Endocrinol. Metab., 41:1025 (1975).
R.A.L. Sutton, Disorders of renal calcium excretion, Kidney Int., 23:665 (1983).
R.A.L. Sutton, Plasma magnesium concentration in primary hyperparathyroidism, Brit. Med. J., 1:529 (1970).
G.A. Quamme, Effect of hypercalcemia on renal tubular handling of calcium and magnesium. Can. J. Physiol. Pharmacol., 60:1275 (1982).
A.R. Lavender, and T.N. Pullman, Changes in inorganic phosphate excretion induced by renal arterial infusion of calcium. Am. J. Physiol., 205:1025 (1963).
D. Rouse, and W.N. Suki, Modulation of phosphate absorption by calcium in the rabbit proximal convoluted tubule, J. Clin. Invest., 76:630 (1986).
E. Eisenberg, Effect of serum calcium level and parathyroid extracts on phosphate and calcium excretion in hypoparathyroid pateints, J. Clin. Invest., 44:942 (1965).
H.O. Heinemann, Metabolic alkalosis in patients with hypercalcemia, Metab. (Clin. Exp.), 14:1137 (1965).
A.A. Siddiqui, and D.R. Wilson, Primary hyperparathyroidism and proximal renal tubular acidosis: Report of two cases. Can. Med. Assoc. J. 106:654 (1972).
C.K. Crumb, M. Martinez-Maldonado, G. Eknoyan, and W.N. Suki, Effects of volume expansion, purified parathyroid extract, and calcium on renal bicarbonate absorption in the dog, J. Clin. Invest., 54:1287 (1974).
T.D. McKinney, and P. Myers, Effect of calcium and phosphate on bicarbonate and fluid transport by proximal tubules in vitro. Kidney Int., 21:433 (1982).
T.D. McKinney, and P. Myers, PTH inhibition of bicarbonate transport by proximal convoluted tubules. Am. J. Physiol., 39:F127 (1980).
H.N. Hulter, A. Sebastian, R.D. Toto, E.L. Bonner Jr., and L.P. Ilnicki, Renal and systemic acid-base effects of the chronic administration of hypercalcemia-producing agents: Calcitriol, PTH, and intravenous calcium. Kidney Int., 21:445 (1982)
H.O. Heinemann, Reversible defect in renal ammonium excretion in patients with hypercalcemia, Metab., 12:792 (1963).
S.L. Cohen, M.C. Fitzgerald, P. Fourman, W.J. Griffith, and H.E. de Wardener, Polyuria in hyperparathyroidism. Quart. J. Med., 26:423 (1957).
M. Levi, L. Peterson, and T. Berl, Mechanism of concentrating defect in hypercalcemia. Role of polydipsia and prostaglandins. Kidney Int., 23:489(1983).
E.R. Serros, and M.A. Kirschenbaum, Prostaglandin-dependent polyuria in hypercalcemia. Am. J. Physiol., 241:F224 (1981).
J.B. Stokes, Effect of prostaglandin E2 on chloride transport across the rabbit thick ascending limb of Henle: Selective inhibition of the medullary portion, J. Clin. Invest., 64:495 (1979).
J.J. Grantham, J. Orloff, Effects of prostaglandin Eon the permeability response of the isolated collecting tubule to vasopressin, adenosine 3,5 monophosphate and theophylline, J. Clin. Invest., 47:1154 (1968).
S. Goldfarb, Effects of calcium on ADH action in the cortical collecting tubule perfused in vitro. Am.J. Physiol., 243:F481 (1982).
G. Frindt, E.E. Windhager, and A. Taylor, Hydroosmotic response of collecting tubules to ADH or cAMP at reduced peritubular sodium. Am. J. Physiol., 243:F503 (1982).
M. Lorenzen, G. Frindt, A. Taylor, and E.E. Windhager, Quinidine effect on hydroosmotic response of collecting tubules to vasopressin and cAMP, Am. J. Physiol., 252:F1103 (1987).
S.M. Jones, G. Frindt, and E.E. Windhager, Effect of peritubular [Ca] or ionomycin on hydroosmotic response of CCTs to ADH or cAMP, Am. J. Physiol., 245:F240 (1988).
H.R. Jacobson, and M.D. Breyer, Phorbol myristate acetate, dioctanoylglycerol, and phosphatidic acid inhibit the hydroosmotic effect of vasopressin on rabbit cortical collecting tubule, J. Clin. Invest., 8:590 (1987).
D.C.H. Harris, P.A. Gabow, S.L. Linas, D.E. Rosendale, S.P. Guggenheim, and R.W. Schrier, Prevention of hypercalcemia-induced renal concentrating defect and tissue calcium accumulation, Am. J. Physiol., 251:F642 (1986).
M.G. Brunette, J. Vary, and S. Carriere, Hyposthenuria in hypercalcemia. A possible role of intrarenal blood-flow (IRBF) redistribution. Pflugers Arch. 350:9 (1974).
N. Beck, H. Singh, and S.W. Reed, Pathogenic role of cyclic AMP in the impairment of urinary concentrating ability in acute hypercalcemia, J. Clin. Invest., 54:1049 (1974).
K. Takaichi, S. Uchida, and K. Kurokawa, High Ca inhibits AVP-dependent cAMP production in thick ascending limbs of Henle, Am. J. Physiol., 250:F770 (1986).
C.E. Dent, Some problems of hyperparathyroidism, Brit. Med. J., 2:1419 (1962).
H.M. Lloyd, Primary hyperparathyroidism. Analysis of the role of the parathyroid tumor. Medicine, 47:53 (1968).
C.E. Ganote, D.J. Philipsborn, E. Chen, and F.A. Carone, Acute calcium nephrotoxicity: an electron microscopical and semiquantitative light microscopical study. Arch. Pathol., 99:650 (1975).
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© 1989 Plenum Press, New York
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Suki, W.N. (1989). Hypercalcemia and the Kidney. In: Amerio, A., Coratelli, P., Campese, V.M., Massry, S.G. (eds) Drugs, Systemic Diseases, and the Kidney. Advances in Experimental Medicine and Biology, vol 252. Springer, Boston, MA. https://doi.org/10.1007/978-1-4684-8953-8_14
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DOI: https://doi.org/10.1007/978-1-4684-8953-8_14
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