Korean Journal of Nephrology 1987;6(2):311-319.

신증후군 환아의 혈청 칼슘에 관한 연구

최동훈 , 진동규 , 이정배 , 김병길

Abstract

Hypocalcemia is a well recognized metabolic disorder in nephrotic syndrome, but the change in serum ionized calcium is still controversial. If serum ionized calcium is reduced in the nephrotic phase, bone development may be delayed or interrupted. We studied the change in calcium and serum ionized calcium in 14 cases of ne- phrotic syndrome. The results are as follows: 1) Of the 14 cases, there were 13 male and 1 female patients. The duration of the disease ranged from 1 month to 8 years 4 months (mean: 2.3 years). Four cases were classified as frequent relapsers and three as infrequent relapsers. 2) Serum calcium level in the nephrotic phase was 7. 06±0.77 mg/dl, which was markedly less than of the remission phase (8.71±0.50mg/dl). Serum phosphorus in the nephrotic phase was 5.06±0.73 mg/dl, no different from that of the remission phase. 3) Serum ionized calcium in the nephrotic phase was 3.98±0.44 mg/dl and there was no change when compar- ed with that in the remission phase (3.76±0.74 mg/dl). 4) 24 hour urinary calcium excretion was 61.11±25.79 mg/day in the nephrotic phase. It was slightly less than that in the remission phase (106.87±59.80 mg/day). 5) The level of parathyroid hormone was 0.47± 0.10 ng/ml in nephrotic phase, which was higher than that in the remission phase (0.33±0.12 ng/ml). 6) Correlation between serum ionized calcium and parathyroid hormone was low. Correlation between duration of the disease and serum ionized calcium was low. Correlation between serum calcium and parathyroid hormone was moderate. The more parathyroid hormone, the less urinary cal- cium, therefore we found that there was a reduction in serum calcium but not in serum ionized calcium. This results cannot support the fact that hypocalcemia in nephrotic syndrome need not to be treated. Studies of vitamin D and bone modulation remain to be demonstrated.