Skip to main content

Advertisement

SpringerLink
Log in

The effect of age on the renal response to PTH infusion

  • Clinical Investigations
  • Published:
Calcified Tissue International Aims and scope Submit manuscript

Summary

The renal responses to PTH infusion were compared in two age groups of healthy subjects. Basal nephrogenous cyclic AMP (NcAMP) was higher (1.68±0.74 vs. 0.97±0.50 nmol/dl GF;P<0.05) and TmPO4/GFR was lower (0.93±0.21 vs. 1.16±0.14 mmol/liter;P<0.025) in 10 elderly subjects compared with 12 young adults. Creatinine clearance was decreased in the elderly (84.8±25.7 vs. 144.7±43.2 ml/min;P<0.005) and serum iPTH tended to be increased (0.15±0.11 vs. 0.11±0.03 pmol/liter). Following the infusion of 3 IU bPTH/kg bodyweight, no significant differences in ΔNcAMP and ΔTmPO4/GFR were seen between the groups. When responses were expressed as percentual change of basal level, elderly subjects showed a % NcAMP of 1831±1200 which was comparable with 2038±1503% in young adults. However, the percentual change in TmPO4/GFR was significantly higher in elderly persons (24.2±11.9 vs. 11.9±8.0%;P<0.01). In young subjects, virtually absent TmPO4/GFR responses were found in 3 cases with a relatively low basal TmPO4/GFR (between 0.92 and 0.98 mmol/liter), but these cases showed normal increases in NcAMP. Elderly subjects retained a considerable ΔTmPO4/GFR notwithstanding a basal TmPO4/GFR below 0.92 in seven out of 10 cases. These results confirm the existence of a slight increase in parathyroid activity in the elderly. In addition, they suggest an augmented sensitivity of the renal tubule concerning PO4 reabsorption in elderly subjects. It is speculated that this phenomenon is related to the fall in bone mineral retention in senescence and might reflect a defense mechanism against phosphate overload.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Marcus R, Madvig PH, Young G (1984) Age-related changes in parathyroid hormone and parathyroid hormone action in normal humans. J Clin Endocrinol Metab 58:223

    PubMed  CAS  Google Scholar 

  2. Insonga KL, Lewis AN, Lipinski BA, Bryant C, Barin DT (1981) Effect of age on serum immunoreactive parathyroid hormone and its biological effects. J Clin Endocrinol Metab 53:1072

    Google Scholar 

  3. Tovey KC, Oldham KG, Whelan JAM (1974) A simple direct assay for cyclic AMP in plasma and other biological samples using an improved competitive protein-binding technique. Clin Chim Acta 56:221

    Article  PubMed  CAS  Google Scholar 

  4. Naafs MAB, Van der Velden PC, Fischer HRA, Koorevaar G, Van Duin S, Hackeng WHL, Schopman W, Silberbusch J (1984) Changes in nephrogenous cyclic AMP excretion and plasma cyclic AMP following treatment of hyperthyroidism. Acta Endocrinol (Copenh) 106:477

    CAS  Google Scholar 

  5. Walton RJ, Bijvoet OLM (1975) Nomogram for derivation of renal threshold phosphate concentration. Lancet II:309

    Article  Google Scholar 

  6. Lindall AW, Elting S, Ells J, Roos BA (1983) Estimation of biologically active intact parathyroid hormone in normal and hyperparathyroid sera by sequential N-terminal immuno-extraction and midregion radioimmunoassay. J Clin Endocrinol Metab 57:1007

    Article  PubMed  CAS  Google Scholar 

  7. Dorn G, Montz R (1977) The preparation of human PTH standard from75Se-labeled medium of tissue culture. Abstracted Acta Endocrinol (Copenh) (Suppl) 208:95

    Google Scholar 

  8. Hackeng WHL, Lips P, Netelenbos CJ, Lips CJM (1986) Clinical implications of estimation of intact parathyroid hormone (PTH) versus total immunoreactive PTH in normal subjects and hyperparathyroid patients. J Clin Endocrinol Metab 63:447

    PubMed  CAS  Google Scholar 

  9. Lequin RM, Hackeng WHL, Schopman W (1970) A radioimmunoassay for parathyroid hormone in man. Acta Endocrinol (Copenh) 57:1007

    Google Scholar 

  10. Atkinson MJ, Jüppner H, Niepel B, Casaretto M, Zahn H, Hesch RD (1982) Characterization of the binding sites of anti-parathyroid hormone antisera using synthetic parathyroid hormone peptides. J Immunoassay 3:31

    PubMed  CAS  Google Scholar 

  11. Lund B, Sørensen OH (1979) Measurement of 25-hydroxy-vitamin D in serum and its relationship to sunshine, age and vitamin D intake in the Danish population. Scand J Clin Lab Invest 39:23

    PubMed  CAS  Google Scholar 

  12. Imanaka S, Ouishi S, Morimoto S, Takamoto S, Kohno H, Kumahara Y (1985) Comparison of renal response to synthetic human PTH (1–34) administration in normal young and elderly male subjects. Calcif Tissue Int 37:357

    PubMed  CAS  Google Scholar 

  13. Thode J, Nistrup/Holmegaard S (1983) The phosphaturic response to parathyroid hormone. N Engl J Med 308:104

    PubMed  CAS  Google Scholar 

  14. Thode J, Børresen T, Madsen SN (1982) The effects of parathyroid hormone on renal function in normal individuals and patients with pseudo-hypoparathyroidism. Ugeskr Laeger 144:1771

    PubMed  CAS  Google Scholar 

  15. Moses AM, Breslau N, Coulson R (1976) Renal responses to PTH in patients with hormone-resistant (pseudo) hypoparathyroidism. Am J Med 61:184

    Article  PubMed  CAS  Google Scholar 

  16. Drezner M, Neelon FA, Lebovitz HE (1973) Pseudohypoparathyroidism type II, a possible defect in the reception of the cyclic AMP signal. N Engl J Med 289:1056

    Article  PubMed  CAS  Google Scholar 

  17. Webster SK, Haramati A (1984) The renal response to parathyroid hormone in immature rats. Abstract 63A, 9th Int Cong Nephrology, Los Angeles

  18. Massry SG, Coburn JW, Lee DNB, Jowsey J, Kleeman CR (1973) Skeletal resistance to parathyroid hormone in renal failure. Ann Int Med 78:357

    PubMed  CAS  Google Scholar 

  19. Steele TH, De Luca HF (1976) Influence of dietary phosphorus on renal phosphate reabsorption in the parathyroidectomized rat. J Clin Invest 57:867

    Article  PubMed  CAS  Google Scholar 

  20. Troehler U, Bonjour JP, Fleisch H (1976) Inorganic phosphate homeostasis. Renal adaption to the dietary intake in intact and thyroparathyroidectomized rats. J Clin Invest 57:264

    CAS  Google Scholar 

  21. Bonjour JP, Troehler U, Preston C, Fleisch H (1978) Parathyroid hormone and renal handling of Pi: effect of dietary Pi and diphosphonates. Am J Physiol 234:F497

    PubMed  CAS  Google Scholar 

  22. Naafs MAB, Fischer HRA, van der Velden PC, Mulder H, Hackeng WHL, Schopman W, Koorevaar G, Silberbusch J (1986) End-organ resistance to PTH-infusion in hypercalcaemic and normocalcaemic patients with solid tumours. Acta Endocrinol (Copenh) 113:543–550

    CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Medicine, Chemistry, and Endocrinology, Municipal Hospital Bergweg, Rotterdam, The Netherlands

    M. A. B. Naafs, H. R. A. Fischer, G. Koorevaar, W. H. L. Hackeng, W. Schopman & J. Silberbusch

Authors
  1. M. A. B. Naafs
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. H. R. A. Fischer
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. G. Koorevaar
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. W. H. L. Hackeng
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. W. Schopman
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. J. Silberbusch
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Naafs, M.A.B., Fischer, H.R.A., Koorevaar, G. et al. The effect of age on the renal response to PTH infusion. Calcif Tissue Int 41, 262–266 (1987). https://doi.org/10.1007/BF02555227

Download citation

  • Received:

  • Revised:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF02555227

Keywords

Search

Navigation