CALCIUM-METABOLISM IN ELDERLY HYPERTENSIVE PATIENTS - POSSIBLE PARTICIPATION OF EXAGGERATED SODIUM, CALCIUM AND PHOSPHATE EXCRETION
CALCIUM-METABOLISM IN ELDERLY HYPERTENSIVE PATIENTS - POSSIBLE PARTICIPATION OF EXAGGERATED SODIUM, CALCIUM AND PHOSPHATE EXCRETION
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DOI：
10.1111/j.1440-1681.1991.tb01637.x
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发表时间：
1991-09-01
影响因子：
2.9
通讯作者：
OGIHARA, T
中科院分区：
文献类型：
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作者：
IMAOKA, M;MORIMOTO, S;OGIHARA, T
1. 我们比较了27名老年高血压女性（平均年龄80 +/- 9岁）、44名老年正常女性（79 +/- 9岁）和19名年轻正常女性（23 +/- 4岁）在生理盐水输注（20 mL/kg，静脉注射2小时）后肾脏对电解质（包括钙）的处理以及钙调节激素的基础循环水平。老年高血压女性在生理盐水输注后尿量和尿中钠（Na）、钙（Ca）和无机磷酸盐(P)的排泄量明显增加，与其他组相比，血液中钠（Na）和离子钙（Ca）的水平有轻微但显著的下降。老年高血压患者在循环血压和钙调节因子方面均表现出特征性；与年轻对照组和血压正常的老年女性相比，她们的血浆肾素活性和醛固酮浓度明显较低，血浆房利钠肽和去甲肾上腺素水平明显较高。此外，与其他组相比，他们的甲状旁腺激素和1,25-二羟基维生素D的基础血清水平显著升高，降钙素、25-羟基维生素D和24,25-二羟基维生素D的基础血清水平显著降低。上述结果提示，老年低肾素高血压患者钙代谢异常可能与尿中钙、磷的过量丢失相关的重度尿钠有关。
1. Renal handling of electrolytes, including calcium (Ca), in response to physiological saline infusion (20 mL/kg, i.v., for 2 h) as well as basal circulating levels of Ca-regulating hormones were compared in 27 hypertensive elderly females (mean age 80 +/- 9 years), in 44 normotensive elderly females (79 +/- 9 years) and in 19 young normotensive females (23 +/- 4 years).2. The hypertensive elderly females showed excessive increase in urine volume and urinary excretions of sodium (Na), Ca and inorganic phosphate (P) in response to saline infusion, associated with slight but significant decrease in circulating levels of Na and ionized Ca compared with those in the other groups. These hypertensive elderly patients also showed characteristic features both in circulating blood pressure and Ca regulating factors; they showed significantly low levels of plasma renin activity and aldosterone concentration, significantly high plasma levels of atrial natriuretic peptide and noradrenalin, compared with those in young controls and normotensive elderly females.3. Moreover they showed significant increase in basal serum levels of parathyroid hormone and 1,25-dihydroxyvitamin D, and significant decrease in basal serum levels of calcitonin, 25-hydroxyvitamin D and 24,25-dihydroxyvitamin D, compared with those in the other groups.4. These results suggest that the exaggerated natriuresis associated with excessive loss of Ca and P in urine may participate in the abnormality of Ca metabolism in low-renin hypertensive elderly patients.