Siddiqui AA, Wilson DR. Primary hyperparathyroidism and proximal renal tubular acidosis: report of two cases.
CANADIAN MEDICAL ASSOCIATION JOURNAL 1972;
106:654-9. [PMID:
5012229 PMCID:
PMC1940492]
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Abstract
Two cases of primary hyperparathyroidism due to single parathyroid adenomas presented with the additional feature of hyperchloremic acidosis. The defect in urinary acidification responsible was not of the distal or gradient-limited type since both patients could lower urine pH adequately. However, there was a defect of bicarbonate reabsorption, an abnormality referred to as the proximal or rate-limited type of renal tubular acidosis. It is suggested that this defect represents an exaggeration of the physiological effect of parathormone on bicarbonate reabsorption and may be responsible for the frequent finding of hyperchloremia in association with primary hyperparathyroidism as well as for the urinary bicarbonate-wasting associated with a variety of causes of secondary hyperparathyroidism.
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