Load Tests of the Renal form of Primary Hyperparathyroidism in Children

Load Tests of the Renal form of Primary Hyperparathyroidism in Children

  • Abdusattor Akhatovich Nasirov Department of Faculty Pediatric Surgery, Tashkent Pediatric Medical Institute, Tashkent, Uzbekistan
  • Bayakhmedov Fathulla Faizievich Department of Faculty Pediatric Surgery, Tashkent Pediatric Medical Institute, Tashkent, Uzbekistan
Keywords: Load test, hyperparathyroidism, renal, children, hypercalciuria

Abstract

After the introduction of calcium chloride (12.4 mg/kg) examined the levels in the blood at 20 and 120 minutes. The calcium content in a comparison group of children after 120 minutes returned to the baseline, in patients with a renal form of primary hyperparathyroidism its level was greater than 1.3 times. The test was sensitive and provided an opportunity to reveal hypercalcemia in 39 children who had been the normo- and hypocalcemia. The impaired renal function had no effect on the significance of the test. Osmotic hypertension develops under the influence of hypertonic sodium chloride. In osmotic diuresis, the excretions of calcium and sodium cations are interdependent.  Increasing sodium in the loops of Henle and distal renal tubules stimulates sodium excretion, decreased reabsorption, which leads to increased levels of calcium in the daily urine in children with primary hyperparathyroidism. Test with sodium chloride made it possible to detect hypercalciuria in 12 (21.43%) children who have had normal levels of calcium in urine.

References

Bilezikian JP, Brandi ML, Rubin M, Silverberg SJ. Primary hyperparathyroidism: new concepts in clinical, densitometric and biochemical features. J Intern Med. 2005;257(1):6-17. doi: 10.1111/j.1365-2796.2004.01422.x.

Riedmiller H, Androulakakis P, Beurton D, Kocvara R, Gerharz E; European Association of Urology. EAU guidelines on paediatric urology. Eur Urol. 2001;40(5):589-99. doi: 10.1159/000049841.

Bergenfelz A, Lindblom P, Lindergård B, Valdemarsson S, Westerdahl J. Preoperative normal level of parathyroid hormone signifies an early and mild form of primary hyperparathyroidism. World J Surg. 2003;27(4):481-5. doi: 10.1007/s00268-002-6649-1.

Abboud B, Sleilaty G, Braidy C, Ghorra C, Abadjian G, Tohme C, et al. Enlarged parathyroid glands discovered in normocalcemic patients during thyroid surgery. Am J Surg. 2008;195(1):30-3. doi:10.1016/j.amjsurg.2007.01.033.

Mitre N, Mack K, Babovic-Vuksanovic D, Thompson G, Kumar S. Ischemic stroke as the presenting symptom of primary hyperparathyroidism due to multiple endocrine neoplasia type 1. J Pediatr. 2008;153(4):582-5. doi: 10.1016/j.jpeds.2008.04.070.

Sneider MS, Solorzano CC, Montano RE, Anello C, Irvin GL 3rd, Lew JI. Sporadic primary hyperparathyroidism in young individuals: different disease and treatment? J Surg Res. 2009;155(1):100-3. doi:10.1016/j.jss.2008.07.041.

George J, Acharya SV, Bandgar TR, Menon PS, Shah NS. Primary hyperparathyroidism in children and adolescents. Indian J Pediatr. 2010;77(2):175-8.

Walker MD, Bilezikian JP. Primary hyperparathyroidism: recent advances. Curr Opin Rheumatol. 2018;30(4):427-439. doi: 10.1097/BOR.0000000000000511.

Hedbäck GM, Odén AS. Cardiovascular disease, hypertension and renal function in primary hyperparathyroidism. J Intern Med. 2002;251(6):476-83. doi: 10.1046/j.1365-2796.2002.00984.x.

Tassone F, Guarnieri A, Castellano E, Baffoni C, Attanasio R, Borretta G. Parathyroidectomy Halts the Deterioration of Renal Function in Primary Hyperparathyroidism. J Clin Endocrinol Metab. 2015;100(8):3069-73. doi: 10.1210/jc.2015-2132.

Published
2022-12-04