Hyperparathyroidism Associated with Distal Tubular Dysfunction but Intact Reabsorption of Protein in the Proximal Tubules

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Abstract
The urinary output of .beta.2-microglobulin was measured in 10 hypercalcemic patients undergoing surgery because of hyperparathyroidism. In 3 subjects the .beta.2-microglobulin excretion was abnormally increased and in 7 patients it was normal before surgery. Three of these 7 patients displayed markedly impaired distal tubular function with a reduced urinary concentration capacity. After surgery all patients became normocalcemic and the urinary concentrating capacities improved. The .beta.2-microglobulin excretion remained unchanged. Thus, hypercalcemia per se does not readily affect the proximal tubular function of reabsorbing low MW proteins. Tubular proteinuria, if found in patients with hypercalcemia, should be suspected to reflect damage to the kidney by additional mechanisms.

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