Studies on the Mechanism of Phosphorus Excretion in Vitamin D Resistant Rickets

Abstract
Two patients with vitamin D resistant rickets respond to a high P intake by a positive Ca balance. The response to a Ca infusion suggests a parathyroid effect on phosphaturia but the size and histology of the parathyroid glands in one patient was normal. A circadian P excretion rhythum was present. Studies of the effect of glucose on the renal handling of P in these patients suggest an inhibitory effect which is lacking in normals. It is postulated that 1 of 2 metabolic pathways for the renal tubular reabsorption of P is absent in vitamin D resistant rickets.

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