Gastric Acid Secretion, Calcitonin and Secondary Hyperparathyroidism in Uremic Patients Undergoing Regular Dialysis Therapy (RDT)

Abstract

Fortyseven uremic patients on RDT underwent a gastric secretion study and a contemporary evaluation of serum levels of Calcium (Ca), Phosphate (iP), Magnesium (Mg), Alkaline Phosphatase (AP), immunoreactive gastrin (Gas), parathyroid hormone (PTH), calcitonin (CT). Secretory test (pentagastrin 6 μg/kg) was performed in the morning, after 12 hours of fasting, in the interdialytic interval. Female patients, male patients on RDT from less 1 year and hyposecretor patients were excluded from the study. On the basis of these criteria 25 normal or hyper-secretor males between 20 and 55 years old were selected. A significant positive correlation was found between PTH and CT, while a negative significant correlation was found between CT and BAO and CT and PAO. Similarly, a significant negative correlation was found between PTH and BAO and PTH and PAO. Multiple regression study showed that the negative influence of CT on BAO and PAO is more relevant than the positive influence of PTH. These data suggest that PTH and CT are involved in gastric acid secretion in uremia. Since the inhibitory effect of CT is prevailing on the stimulating effect of PTH, patients with higher levels of PTH and CT have a lower gastric acid secretion. CT might therefore be considered as a protective factor against hypersecretion in uremia.