Urinary excretion of cyclic AMP in bacterial infections

Urinary cyclic AMP excretion was found to be increased in patients with severe bacterial infections and normal renal function. The observed changes appeared due to a combination of an increased filtered load plus augmented "nephrogenous" production in some patients; while in others, only an increase in the apparent "nephrogenous" production of cAMP could be found to account for the elevation in the total urinary excretion. Since total serum calcium was found to be low in most of these patients, increased PTH secretion to reduce urinary excretion of calcium may have been responsible for an increase in renal parenchymal production, and subsequent excretion of cyclic AMP. Although speculative, this theory is tenable in that ionized hypocalcemia exists in septic patients.