CORRECTION OF ACIDOSIS IN HEMODIALYSIS-PATIENTS INCREASES THE SENSITIVITY OF THE PARATHYROID-GLANDS TO CALCIUM

Correction of acidosis in hemodialysis patients increases the sensitiv ity of the parathyroid glands to calcium. In this study, the parathyro id response to the correction of acidosis in eight hemodialysis patien ts was determined by performing dynamic assessment of parathyroid func tion before and after the correction of acidosis. The parathyroid resp onse to intravenous calcitriol before and after the correction of acid osis was also assessed. After optimal correction of acidosis, there we re no significant changes in blood pH, ionized calcium, phosphate, or alkaline phosphatase values, but the level of venous total CO2 increas ed significantly. Parathyroid hormone/ionized calcium curves were disp laced downward after correction of acidosis, but not after the adminis tration of intravenous calcitriol. The correction of metabolic acidosi s in hemodialysis patients with secondary hyperparathyroidism can supp ress parathyroid hormone secretion by increasing the sensitivity of th e parathyroid glands to ionized calcium.