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We studied the effects of bilateral nephrectomy on bone metabolism in 27 patients on maintenance hemodialysis. After nephrectomy plasma alkaline phosphatase fell rapidly in 10 patients whose preoperative plasma levels had been higher than normal. This fall was associated with a transient decrease in osteoblast counts of iliac-bone biopsies. A fall in plasma phosphate and a rise in plasma immunoreactive calcitonin also occurred, but calcium and immunoreactive parathyroid hormone levels did not change. Alkaline phosphatase levels remained unchanged in a control group of 17 patients on dialysis who had undergone an operation other than nephrectomy. In 26 nonsurgical patients on dialysis, immunoreactive calcitonin was inversely related to osteoblast counts. Rises in immunoreactive calcitonin may be partly responsible for the transient decreases in bone turnover after bilateral nephrectomy. Low levels of endogenous calcitonin may allow an increase in bone turnover in chronic renal failure.

Original publication

DOI

10.1056/nejm197705122961901

Type

Journal article

Journal

The New England journal of medicine

Publication Date

05/1977

Volume

296

Pages

1073 - 1079

Keywords

Bone and Bones, Kidney, Humans, Kidney Failure, Chronic, Phosphates, Calcium, Calcitonin, Alkaline Phosphatase, Renal Dialysis, Nephrectomy, Adolescent, Adult, Middle Aged, Female, Male, Chronic Kidney Disease-Mineral and Bone Disorder