pituitrin and Hyperparathyroidism

Ageing of the kidneys has long been associated with a fall in the number of functioning nephrons resulting in a reduction of renal blood flow and glomerular filtration. This narrow concept of age-related changes in renal function has been developed chiefly during the last few years by Brenner et al. on the basis of experimental studies conducted on rodents. According to these authors, the size and frequency of segmental and focal lesions of glomerulosclerosis increase regularly with age, and in its final phase this pathology results in occlusion of glomerular capillaries. Renal ageing, therefore, can be assimilated to the nephron reduction models obtained by surgical ablation. The hypothesis that hypofiltration in certain nephrons is compensated by hyperfiltration in healthy glomerulis, leading to a vicious circle of self-destruction, was then applied to both ageing and experimental renal impairment: the smaller the number of nephrons, the greater the filtration achieved by the remaining nephrons, a process that accelerates the probability of their destruction. Conversely, any attempt to reduce intracapillary pressure or glomerular filtration slows down the progression of renal failure. This hypothesis is supported by experiments showing that reduction of protein intake or chronic inhibition of angiotensin I-converting enzyme activity are truly capable of limiting the progression of glomerulosclerosis induced in rats by partial renal mass ablation. Similarly, prolonged food restriction increases the life expectancy of rodents and almost totally prevents the occurrence of glomerulosclerosis. The experimental finding that degenerative renal lesions do not necessarily develop with age raises the problem of normal and pathological ageing. With an adequate choice of rats' food, strain and sanitary surroundings it is possible to obtain very old animals devoid of occluded glomerular capillaries and loss of nephron. What about the functional and structural changes due to ageing and not to pathology? This question has given rise to numerous studies which concluded, on the whole, that there exists a normal ageing of the kidneys without loss of nephron and that ageing is expressed by the fact that the kidneys have difficulties in adjusting themselves to disturbances in the inner environment. As regards renal functional reserve, response to the antidiuretic hormone in case of water restriction, or stimulation of the renin-angiotensin system in response to decrease of

Topics: Aging; Angiotensin-Converting Enzyme Inhibitors; Animals; Glomerular Filtration Rate; Glomerulosclerosis, Focal Segmental; Hydronephrosis; Hyperparathyroidism; Kidney; Kidney Concentrating Ability; Kidney Failure, Chronic; Nephrons; Rats; Vasopressins

Topics: Calcium; Catecholamines; Circadian Rhythm; Clinical Trials as Topic; Cyclic AMP; Cyclic GMP; Glucagon; Humans; Hyperparathyroidism; Hypoparathyroidism; Kinetics; Methods; Nephrons; Parathyroid Hormone; Reference Values; Thyroid Gland; Vasopressins

Topics: Adrenocortical Hyperfunction; Adult; Carcinoid Heart Disease; Cushing Syndrome; Endocrine System Diseases; Gynecomastia; Humans; Hypercalcemia; Hyperparathyroidism; Hyperthyroidism; Hyponatremia; Lung Neoplasms; Male; Middle Aged; Osmolar Concentration; Osteoarthropathy, Secondary Hypertrophic; Syndrome; Vasopressins

Topics: Adolescent; Bronchial Neoplasms; Carcinoma, Small Cell; Child, Preschool; Cushing Syndrome; Diagnosis, Differential; Hormones, Ectopic; Humans; Hyperaldosteronism; Hypercalcemia; Hyperparathyroidism; Hyponatremia; Kidney Neoplasms; Paraneoplastic Endocrine Syndromes; Renin; Sodium Chloride; Syndrome; Vasopressins

Topics: Affective Symptoms; Animals; Asthma; Caffeine; Calcitonin; Calcium; Catecholamines; Circadian Rhythm; Cyclic AMP; Cyclic GMP; Dermatitis, Atopic; Diabetes Insipidus; Glucagon; Growth Hormone; Humans; Hypercalcemia; Hyperparathyroidism; Hypocalcemia; Hypoparathyroidism; Insulin; Organ Specificity; Parathyroid Hormone; Psoriasis; Vasopressins

Topics: Animals; Biological Transport; Creatinine; Cyclic AMP; Cyclic GMP; Escherichia coli; Extracellular Space; Glucagon; Humans; Hyperparathyroidism; Hypoparathyroidism; Kinetics; Parathyroid Hormone; Perfusion; Pseudohypoparathyroidism; Vasopressins

Topics: Addison Disease; Animals; Calcitonin; Glucocorticoids; Growth Hormone; Hormones; Humans; Hyperaldosteronism; Hyperparathyroidism; Hyperthyroidism; Hypoparathyroidism; Insulin; Intestinal Absorption; Magnesium; Parathyroid Hormone; Rats; Vasopressins; Vitamin D

Topics: Extracellular Space; Humans; Hypercalcemia; Hyperkalemia; Hypernatremia; Hyperparathyroidism; Hypokalemia; Kidney; Magnesium; Vasopressins; Water-Electrolyte Balance

Topics: Acromegaly; Addison Disease; Adrenocortical Hyperfunction; Cushing Syndrome; Diabetes Insipidus; Endocrine System Diseases; Humans; Hyperaldosteronism; Hyperparathyroidism; Hypopituitarism; Hypothyroidism; Kidney; Vasopressins; Water-Electrolyte Balance

Topics: Calcium; Catecholamines; Circadian Rhythm; Clinical Trials as Topic; Cyclic AMP; Cyclic GMP; Glucagon; Humans; Hyperparathyroidism; Hypoparathyroidism; Kinetics; Methods; Nephrons; Parathyroid Hormone; Reference Values; Thyroid Gland; Vasopressins

Vasopressin function and thirst were studied in fourteen hypercalcaemic patients (ten hyperparathyroid and four disseminated malignant disease). Ten patients had decreased renal concentrating ability which reversed within a few days in the majority of patients whose hypercalcaemia was corrected by parathyroidectomy. Although eight patients complained of thirst, none showed a lowered threshold of thirst appreciation during hypertonic saline infusion. Osmoregulation of vasopressin secretion was not reduced in any patient, but the hyperparathyroid group had an exaggerated vasopressin response to osmotic stimulation. We conclude that a partial, reversible nephrogenic diabetes insipidus occurs in at least 70% of hypercalcaemic patients irrespective of cause, which accounts for the polyuria induced by hypercalcaemia.

Topics: Adult; Aged; Deamino Arginine Vasopressin; Female; Humans; Hypercalcemia; Hyperparathyroidism; Kidney; Kidney Concentrating Ability; Male; Middle Aged; Osmolar Concentration; Parathyroid Glands; Thirst; Vasopressins

Topics: Adenocarcinoma; Adrenocortical Hyperfunction; Adrenocorticotropic Hormone; Bronchial Neoplasms; Carcinoma; Female; Gastrointestinal Neoplasms; Gonadotropins; Growth Hormone; Hormones, Ectopic; Humans; Hyperparathyroidism; Hyperthyroidism; Lung Neoplasms; Male; Paraneoplastic Endocrine Syndromes; Parathyroid Hormone; Pituitary Hormones; Sex Factors; Thymus Neoplasms; Thyroid Neoplasms; Thyrotropin; Urogenital Neoplasms; Vasopressins

Topics: Acute Kidney Injury; Calcitonin; Calcium; Diet; Diuretics; Glomerular Filtration Rate; Glucocorticoids; Growth Hormone; Humans; Hyperparathyroidism; Hypoparathyroidism; Kidney; Kidney Concentrating Ability; Magnesium; Natriuresis; Parathyroid Hormone; Phosphates; Thyroxine; Vasopressins; Vitamin D

Investigation of a patient with hypercalcaemia, hypophosphataemia, and nephrocalcinosis failed to lead to a clear diagnosis. Neither primary hyperparathyroidism nor primary incomplete renal tubular acidosis could explain all the biochemical features, and it seems that more than one fundamental abnormality may have been present.

Topics: Acidosis; Acidosis, Renal Tubular; Adolescent; Ammonium Chloride; Calcium; Calcium, Dietary; Diagnosis, Differential; Humans; Hydrogen-Ion Concentration; Hypercalcemia; Hyperparathyroidism; Male; Nephrocalcinosis; Osmolar Concentration; Phosphates; Urine; Vasopressins

Ectopic production of polypeptide hormones by tumors of nonendocrine tissues can serve as a clue to diagnosis of the tumor and as a focus for management of the patient with cancer. In the differential diagnosis of syndromes of endocrine hyperfunction, the ectopic hormone syndromes have achieved an increasingly prominent position. Available evidence on the properties of ectopic ACTH, MSH, parathyroid hormone, erythropoietin, gonadotropins, and thyrotropin is consistent with the unifying hypothesis of genetic derepression.

Topics: Abdominal Neoplasms; Adenocarcinoma; Adrenocortical Hyperfunction; Brain Neoplasms; Carcinoma, Bronchogenic; Carcinoma, Hepatocellular; Carcinoma, Small Cell; Cysts; Diagnosis, Differential; Fibroma; Hemangiosarcoma; Humans; Hyperparathyroidism; Hypoglycemia; Kidney Diseases; Kidney Neoplasms; Liver Neoplasms; Lung Neoplasms; Paraneoplastic Endocrine Syndromes; Pheochromocytoma; Polycythemia; Sarcoma; Thoracic Neoplasms; Vasopressins

Topics: Adenine Nucleotides; Adolescent; Adult; Aged; Chronic Disease; Circadian Rhythm; Creatinine; Cyclic AMP; Female; Glomerulonephritis; Glucagon; Growth Hormone; Humans; Hyperparathyroidism; Hypoparathyroidism; Male; Menstruation; Middle Aged; Osmolar Concentration; Parathyroid Hormone; Phosphates; Pregnancy; Pyelonephritis; Tritium; Urine; Vasopressins

Topics: Adrenalectomy; Adrenocorticotropic Hormone; Alkalosis; Autoimmune Diseases; Bone Diseases; Carcinoma, Bronchogenic; Cushing Syndrome; Endocrine System Diseases; Hypercalcemia; Hyperparathyroidism; Hyponatremia; Lung Neoplasms; Metabolic Diseases; Neoplasm Metastasis; Neurologic Manifestations; Neuromuscular Diseases; Skin Diseases; Skin Manifestations; Vascular Diseases; Vasopressins

Topics: Adolescent; Adult; Alkaline Phosphatase; Blood Urea Nitrogen; Calcinosis; Calcium; Chronic Disease; Creatinine; Female; Humans; Hyperparathyroidism; Kidney Concentrating Ability; Kidney Diseases; Kidney Tubules; Male; Middle Aged; Osmolar Concentration; Phosphorus; Potassium; Sodium; Urea; Vasopressins