RENAL TUBULAR ACIDOSIS FROM THE ASPECT OF THE KINETICS OF SERUM CALCIUM

Abstract

It has been discussed whether parathyroid function on the distal type of renal tubular acidosis (distal RTA) may be activated and result in the negative balance of calcium and inorganic phosphorus.
However, its etiology is obscure.
We reported herein a case of distal RTA that was studied as to serum ionized calcium, inorganic phosphorus and serum parathyroid hormone (PTH) before and after the therapy of the acidosis. The results showed that serum ionized calcium was increased, although total serum calcium was at the lower limit of the normal range and serum PTH level was low (0.1ng/dl) in systemic acidosis before the therapy.
After recovery from the acidosis serum ionized calcium was decreased to the normal range with increased total serum calcium and serum PTH (1.2ng/dl).
Therefore, the parathyroid function on the distal RTA is thought to be mediated by serum ionized calcium.