Mechanism of the polyuria of hypercalcemia.
Mechanism of the polyuria of hypercalcemia.
复制标题
高钙血症多尿的机制。
DOI：
10.1159/000166780
复制
发表时间：
1984
影响因子：
4.2
通讯作者：
Agus,ZS
中科院分区：
文献类型：
--
作者：
Goldfarb,S;Agus,ZS
Polyuria is considered a classical symptom of hyper calcemia and was a presenting feature of the first case of hyperparathyroidism described in the medical literature. The patient had been ‘seized with a diabetes, and the usual symptoms viz. a frequent and copious discharge by urine, a gradual wasting of the body, a hectic fever with a quick low pulse, thirst, great pain in her shoulders, back and limbs, and loss of appetite’[1], Since that time, many studies have appeared documenting the occurrence of polyuria in hyperparathyroidism [2] as well as in a variety of hypercalcemic disorders [3]. While the polyuria may be less extreme than in the initial case report, this may be a troublesome clinical feature and in addition may ag gravate hypercalcemia if water intake is restricted and volume contraction ensues. The major stimulus for the large number of studies in the literature regarding the mechanism of polyuria in hypercalcemia, however, was the continuing interest of renal physiologists in the mech anisms of urinary concentration and the action of cal cium as an inhibitor of this system. There are several potential sites of action at which a drug or a physiologic disturbance such as elevated cal cium levels may act to interfere with the urinary concen trating mechanism and to produce polyuria. These may be classified as a primary increase in water intake, a reduced osmotic gradient for water abstraction across the collecting duct, or decreased activity of ADH due to either reduced ADH release or reduced renal response to ADH.
