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[Clinical studies on the action of parathyroid hormone on the kidney. I. Factors affecting the renal phosphaturic response of parathyroid hormone].

It has been well known for many years that the administration of parathyroid hormone (PTH) increases urinary phosphorus(P) excretion. The previous reports on urinary P diurnal variation and dietary intake of P on the interpretation of phosphaturic response to PTH have led the author to reevaluate factors other than exogenous PTH which rarely produce the inconsistently variable phosphaturic responses following the intravenous injection of PTH. Spontaneous daytime variation of P excretion (ratioof urinary P to urinary creatinine : UP/UCr) in hourly collected urine from 7 a.m. to 5 p.m. and renal phosphaturic responses in the 1st and the 2nd post-PTH hour to intravenously administered PTH were investigated in normal subjects, patients with parathyroiddiseases (hyperparathyroidism, hypoparathyroidism and pseudohypoparathyroidism), patients with renal diseases (tubular rickets, kidney stone and uremia), patients with bone abnormalities (polyostotic fibrous dysplasia, neurofibromatosis, Paget's disease and marble bone disease) and patients with thyroid diseases (hyperthyroid goiter, euthyroid goiter and hypothyroid goiter). In general, UP/UCr was low early in the morning, increased gradually to the maximum at 3 or 4 p.m. and then decreased slowly. In patients with hyperparathyroidism and hyperthyroidism, however, spontaneous daytime rhythm was greatly amplified. On the other hand spontaneous daytime rhythm in patients with hypoparathyroidism, pseudohypo-