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. 1971 Dec;50(12):2689–2702. doi: 10.1172/JCI106770

Renal effects of calcitonin and parathyroid extract in man

Studies in hypoparathyroidism

Heinrich G Haas 1, Maximilian A Dambacher 1, Jan Gunčaga 1, Thierry Lauffenburger 1
PMCID: PMC292219  PMID: 5166965

Abstract

To clarify the controversial renal action of calcitonin (CT) and a possible interrelationship between CT and parathyroid hormone, eight patients with untreated surgical hypoparathyroidism were studied. Various calcitonins, i.e. extracted porcine, synthetic porcine, synthetic human, and synthetic salmon CT in doses of 150 Medical Research Council U or 1.5 mg were infused over a 3 hr period. Subsequently, six of the same subjects received 500 USP U parathyroid extract (PTE) (Eli Lilly & Co., Indianapolis, Ind.) in 3 hr and later a combination of CT and PTE. In addition, two patients were given an infusion of ammonium phosphate with the aim of producting a phosphaturia of comparable degree as seen after CT and PTE, thus differentiating hormonal from nonhormonal influences on cation excretion. A protocol of serial clearance (C) studies using the patients as their own controls was followed. Serum and urinary inorganic phosphate (P), calcium (Ca), magnesium (Mg), sodium (Na), potassium (K), and creatinine (Cr) were determined and the clearance values calculated.

All CT peptides caused a uniform, immediate and significant increase of CP, CNa, CK, CCa, and CMg, PTE evoked a rise of CP, CNa, and CK, but CCa and CMg were reduced, the Ca and Na figures being not statistically significant. The administration of both CT and PTE resulted in a summation of individual hormone effects on Ca and Mg excretion. Phosphate infusion on the other hand induced an isolated phosphaturia but no concomitant changes of the urinary cations.

The hypoparathyroid data demonstrate that calcitonin enhances urinary elimination of P, Na, K, Ca, and Mg independently of parathyroid action, CT and PTE act qualitatively similarly on P, Na, and K excretion, while an antagonism seems to exist for the renal handling of Ca and Mg.

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Selected References

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  1. Ardaillou R., Fillastre J. P., Milhaud G., Rousselet F., Delaunay F., Richet G. Renal excretion of phosphate, calcium and sodium during and after a prolonged thyrocalcitonin infusion in man. Proc Soc Exp Biol Med. 1969 May;131(1):56–60. doi: 10.3181/00379727-131-33803. [DOI] [PubMed] [Google Scholar]
  2. Bijvoet O. L., van der Sluys Veer J., Jansen A. P. Effects of calcitonin on patients with Paget's disease, thyrotoxicosis, or hypercalcaemia. Lancet. 1968 Apr 27;1(7548):876–881. doi: 10.1016/s0140-6736(68)90236-5. [DOI] [PubMed] [Google Scholar]
  3. Burkhart J. M., Jowsey J. Morphologic evidence of osteomalacia in the parathyroidectomized dog. Mayo Clin Proc. 1966 Oct;41(10):663–667. [PubMed] [Google Scholar]
  4. COPP D. H., CAMERON E. C., CHENEY B. A., DAVIDSON A. G., HENZE K. G. Evidence for calcitonin--a new hormone from the parathyroid that lowers blood calcium. Endocrinology. 1962 May;70:638–649. doi: 10.1210/endo-70-5-638. [DOI] [PubMed] [Google Scholar]
  5. Care A. D., Bates R. F., Gitelman H. J. A possible role for the adenyl cyclase system in calcitonin release. J Endocrinol. 1970 Sep;48(1):1–15. doi: 10.1677/joe.0.0480001. [DOI] [PubMed] [Google Scholar]
  6. Clark J. D., Kenny A. D. Hog thyrocalcitonin in the dog: urinary calcium, phosphorus, magnesium and sodium responses. Endocrinology. 1969 May;84(5):1199–1205. doi: 10.1210/endo-84-5-1199. [DOI] [PubMed] [Google Scholar]
  7. Cochran M., Peacock M., Sachs G., Nordin B. E. Renal effects of calcitonin. Br Med J. 1970 Jan 17;1(5689):135–137. doi: 10.1136/bmj.1.5689.135. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Cramer C. F., Parkes C. O., Copp D. H. The effect of chicken and hog calcitonin on some parameters of Ca, P, and Mg metabolism in dogs. Can J Physiol Pharmacol. 1969 Feb;47(2):181–184. doi: 10.1139/y69-031. [DOI] [PubMed] [Google Scholar]
  9. Guttmann S., Pless J., Huguenin R. L., Sandrin E., Bossert H., Zehnder K. Synthese von Salm-Calcitonin, einem hochaktiven hypocalcämischen Hormon. Helv Chim Acta. 1969;52(7):1789–1795. doi: 10.1002/hlca.19690520702. [DOI] [PubMed] [Google Scholar]
  10. Haas H. G., Dambacher M. A. Thyrocalcitonin effects in man. Helv Med Acta. 1968 Nov;34(4):327–336. [PubMed] [Google Scholar]
  11. Haas H. G. Metabolic criteria for primary hyperparathyroidism. Helv Med Acta. 1966 Jun;33(2):91–107. [PubMed] [Google Scholar]
  12. Haas H. G., Olah A. J., Dambacher M. Hypoparathyreoidismus. Gelöste und ungelöste pathophysiologische Fragen. Dtsch Med Wochenschr. 1968 Jul 19;93(29):1383–1389. doi: 10.1055/s-0028-1110748. [DOI] [PubMed] [Google Scholar]
  13. Hellman D. E., Au W. Y., Bartter F. C. Evidence for a direct effect of parathyroid hormone on urinary acidification. Am J Physiol. 1965 Sep;209(3):643–650. doi: 10.1152/ajplegacy.1965.209.3.643. [DOI] [PubMed] [Google Scholar]
  14. Hirsch P. F., Munson P. L. Thyrocalcitonin. Physiol Rev. 1969 Jul;49(3):548–622. doi: 10.1152/physrev.1969.49.3.548. [DOI] [PubMed] [Google Scholar]
  15. Jowsey J., Detenbeck L. C. Importance of thyroid hormones in bone metabolism and calcium homeostasis. Endocrinology. 1969 Jul;85(1):87–95. doi: 10.1210/endo-85-1-87. [DOI] [PubMed] [Google Scholar]
  16. Jowsey J. Serum calcium and phosphate changes in thyroidectomized dogs. Calcif Tissue Res. 1969;4(2):188–192. doi: 10.1007/BF02279121. [DOI] [PubMed] [Google Scholar]
  17. Kahnt F. W., Riniker B., MacIntyre I., Neher R. Thyrocalcitonin. I. Isolierung und Charakterisierung wirksamer Peptide aus Schweineschilddrüsen. Helv Chim Acta. 1968;51(1):214–217. doi: 10.1002/hlca.19680510125. [DOI] [PubMed] [Google Scholar]
  18. Kennedy J. W., 3rd, Tanzer F. S., Talmage R. V. Plasma phosphate and the hypocalcemic response of intact, parathyroidectomized and nephrectomized rats to thyrocalcitonin. Endocrinology. 1969 Oct;85(4):657–661. doi: 10.1210/endo-85-4-657. [DOI] [PubMed] [Google Scholar]
  19. Kenny A. D., Heiskell C. A. Effect of crude thyrocalcitonin on calcium and phosphorus metabolism in rats. Proc Soc Exp Biol Med. 1965 Oct;120(1):269–271. doi: 10.3181/00379727-120-30508. [DOI] [PubMed] [Google Scholar]
  20. Litvak J., Oberhauser E., Riesco J., López O., Armendaris R., Alliende I., Solís F. Strontium-85 kinetics in hypoparathyroidism at different levels of calcium intake. J Nucl Med. 1967 Jan;8(1):60–69. [PubMed] [Google Scholar]
  21. MACINTYRE I. Flame photometry. Adv Clin Chem. 1961;4:1–28. [PubMed] [Google Scholar]
  22. Martin T. J., Melick R. A. The acute effects of porcine calcitonin in man. Australas Ann Med. 1969 Aug;18(3):258–263. doi: 10.1111/imj.1969.18.3.258. [DOI] [PubMed] [Google Scholar]
  23. Pak C. Y., Ruskin B., Casper A. Renal effects of porcine thyrocalcitonin in the dog. Endocrinology. 1970 Aug;87(2):262–270. doi: 10.1210/endo-87-2-262. [DOI] [PubMed] [Google Scholar]
  24. Peacock M., Robertson W. G., Nordin B. E. Relation between serum and urinary calcium with particular reference to parathyroid activity. Lancet. 1969 Feb 22;1(7591):384–386. doi: 10.1016/s0140-6736(69)91353-1. [DOI] [PubMed] [Google Scholar]
  25. Rasmussen H., Anast C., Arnaud C. Thyrocalcitonin, EGTA, and urinary electrolyte excretion. J Clin Invest. 1967 May;46(5):746–752. doi: 10.1172/JCI105575. [DOI] [PMC free article] [PubMed] [Google Scholar]
  26. Rittel W., Brugger M., Kamber B., Riniker B., Sieber P. Thyrocalcitonin. 3. Die synthese des alpha-Thyrocalcitonins. Helv Chim Acta. 1968 May 31;51(4):924–928. doi: 10.1002/hlca.660510431. [DOI] [PubMed] [Google Scholar]
  27. Robinson C. J., Martin T. J., MacIntyre I. Phosphaturic effect of thyrocalcitonin. Lancet. 1966 Jul 9;2(7454):83–84. doi: 10.1016/s0140-6736(66)91807-1. [DOI] [PubMed] [Google Scholar]
  28. Robinson C. J., Martin T. J., Matthews E. W., MacIntyre I. Mode of action of thyrocalcitonin. J Endocrinol. 1967 Sep;39(1):71–79. doi: 10.1677/joe.0.0390071. [DOI] [PubMed] [Google Scholar]
  29. Sieber P., Brugger M., Kamber B., Riniker B., Rittel W. Menschliches Calcitonin. IV. Die Synthese von Calcitonin. Helv Chim Acta. 1968;51(8):2057–2061. doi: 10.1002/hlca.19680510825. [DOI] [PubMed] [Google Scholar]
  30. Steele T. H. Increased urinary phosphate excretion following volume expansion in normal man. Metabolism. 1970 Feb;19(2):129–139. [PubMed] [Google Scholar]
  31. TORIBARA T. Y., TEREPKA A. R., DEWEY P. A. The ultrafiltrable calcium of human serum. I. Ultrafiltration methods and normal values. J Clin Invest. 1957 May;36(5):738–748. doi: 10.1172/JCI103477. [DOI] [PMC free article] [PubMed] [Google Scholar]

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