泌尿器科領域におけるカルシウム代謝異常をきたす疾患の血清イオン化カルシウム測定の意義について

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Physiologically active serum calcium, namely ionized calcium, was measured in hyperparathyroidisms, idiopathic hypoparathyroidism, distal renal tubular acidosis, and renal failures which have an abnormal metabolism of calcium. The results were as follows: 1. In the hyperparathyroidism proved surgically the measurement of the elevated ionized calcium and increased ionized ratio of calcium has clinical value for the diagnosis in the borderline cases. 2. In the idiopathic hypoparathyroidism the ionized calcium and ionized ratio of calcium were lower than controls. These returned to be normal after medication of the V.D_2 and calcium. Therefore, the etiologic factors to give fluctuation of the ionized calcium might be not parathormone (PTH) only but complicated ones. 3. In the distal renal tubular acidosis the etiologic factor for the elevated ionized calcium were suspected to be metabolic acidosis, not PTH. 4. In the renal failure both total serum calcium and ionized calcium were lower than the control values. Among these renal failure patients one case, who had an elevated ionized calcium, showed secondary hyperplasia of the four parathyroid glands microscopically. This means that the measurement of the ionized calcium will be valuable for the diagnosis of secondary hyperparathyroidism. We discussed that the ionized calcium in serum played an important role in disorders of calcium metabolism in the urological field.
社団法人日本泌尿器科学会の論文

泌尿器科領域におけるカルシウム代謝異常をきたす疾患の血清イオン化カルシウム測定の意義について

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