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Elevated serum parathyroid hormone concentration during treatment with high ceiling diuretics
European Journal of Clinical Pharmacology
|October 1, 1980
Summary
Furosemide and bumetanide treatment for heart failure can lower serum calcium, increasing parathyroid hormone (PTH) and alkaline phosphatase. These changes suggest potential bone remodeling effects.
Area of Science:
- Cardiology
- Endocrinology
- Nephrology
Background:
- Congestive heart failure (CHF) management often involves diuretics like furosemide and bumetanide.
- Diuretic therapy can impact electrolyte balance and mineral metabolism.
Purpose of the Study:
- To investigate the effects of furosemide and bumetanide on serum parathyroid hormone (s-PTH), calcium, phosphorus, and alkaline phosphatase levels.
- To understand the potential mechanisms behind observed biochemical changes during diuretic treatment for CHF.
Main Methods:
- Serum levels of s-PTH, calcium, phosphorus, and alkaline phosphatase were measured.
- Patients were undergoing treatment with either furosemide or bumetanide for congestive heart failure.
Main Results:
- A significant increase in s-PTH and alkaline phosphatase was observed.
- Serum calcium concentrations were found to be decreased.
- These biochemical alterations were independent of drug dosage and treatment duration.
Conclusions:
- Furosemide and bumetanide treatment may induce hypocalcemia, leading to elevated s-PTH levels.
- Increased alkaline phosphatase suggests accelerated bone remodeling, similar to findings in primary hyperparathyroidism.