Indices of intact serum parathyroid hormone and renal excretion of calcium, phosphate, and magnesium

Article Abstract:

Normal values of calcium, phosphorus, and magnesium excreted by the kidney in children should be determined to assess disorders of mineral metabolism in childhood. Hypercalcemia, or abnormally high blood levels of calcium, increases the risk of kidney stones and may also contribute to other urinary tract disorders. Hypophosphatemia, or abnormally low blood levels of phosphorus, may result from a defect in the kidney tubules, which absorb phosphorus, or impaired function of parathyroid hormone, which increases phosphorus excretion in the urine. Hypomagnesemia, or abnormally low blood levels of magnesium, may be due to magnesium leak from the kidneys or abnormalities in intestinal magnesium absorption. Hence the normal values for the kidney excretion of calcium, phosphorus, and magnesium were determined for 101 healthy children aged two to 15 years. The normal values for blood levels of intact parathyroid hormone were also determined. Measurements of calcium and magnesium excretion from the kidneys did not correlate with age or sex and a common range of values could be established for all children. The urinary calcium:creatinine and magnesium:creatinine ratios were 0.69 and 1.05 respectively. The value for phosphorus reabsorption, expressed as tubular maximum for phosphate per liter of glomerular filtrate (TmPO4/GFR), was 1.67 millimoles per liter. The normal range of values for blood levels of intact parathyroid hormone was 11 to 35 nanograms per liter. An increase in phosphorus resorption by the kidney was associated with a decrease in the blood levels of parathyroid hormone. (Consumer Summary produced by Reliance Medical Information, Inc.)

Evaluation, Measurement, Physiological aspects, Parathyroid hormone, Parathyroid hormones, Biological transport, Mineral metabolism, Renal tubule, Renal tubular transport

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Progressive renal toxicity due to ifosfamide

Article Abstract:

Ifosfamide is a medication used in chemotherapy when treating solid tumors. It has only been used in children since 1980, when mesna, a uroprotector, was introduced to decrease the severe toxic effects of ifosfamide on the kidney and bladder. There are concerns still about the renal toxicity of ifosfamide, and so kidney functions were evaluated in 11 children before and after treatment with ifosfamide. Both glomerular function (filtration of blood without allowing protein to enter kidney tubules) and tubular function (adjustment of salt and water concentration) were assessed. All patients had signs of kidney toxicity. The urinary levels of two proteins, derived from kidney tubular cells, increased with each course of ifosfamide treatment, while levels of two glomerular proteins increased in only two children, one of whom had previous kidney damage. At follow-up, from six to 14 months later, all seven surviving children continued to have signs of tubular toxicity, and five also had developed signs of glomerular damage. The study indicates that children treated with ifosfamide should be monitored for kidney damage during and after therapy. (Consumer Summary produced by Reliance Medical Information, Inc.)

Injuries, Complications and side effects, Kidneys, Kidney, Ifosfamide

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