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Renal Transport of Phosphate

Yeshawant B. Talwalkar, MD; James E. Musgrave, MD; Neil R. M. Buist, MD; Robert A. Campbell, MD; John R. Campbell, MD

Am J Dis Child. 1974;128(5):704-708.

Abstract
Autonomous hyperparathyroidism in vitamin D-resistant rickets is very rare. A 15-year-old girl with vitamin D-resistant rickets developed persistent hypercalcemia, hypertension, and inability to concentrate urine. Serum parathormone levels were elevated and were not substantially suppressed by calcium infusion. The renal tubular defect in phosphate reabsorption was unaltered during hyperparathyroidism and after removal of 3 of the parathyroid glands. The surgical specimen showed two parathyroid adenomas that were confirmed histologically. These findings support the concept that the primary defect in this disease is in renal tubular reabsorption of phosphate.

Author Affiliations
From the departments of pediatrics (Drs. Talwalkar, Musgrave, Buist, and Robert A. Campbell) and pediatric surgery (Dr. John R. Campbell), University of Oregon Medical School, Portland.

Footnotes
Received for publication Oct 25, 1973; accepted April 3, 1974.

Reprint requests to Department of Pediatrics, Renal-Metabolic Laboratory, University of Oregon Medical School, 3181 SW Sam Jackson Park Rd, Portland, OR 97201 (Dr. Talwalkar).

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