Effects of acetazolamide on the renal excretion of phosphate in hypoparathyroidism and pseudohypoparathyroidism

Tushar K. Sinha, Donald O. Allen, Sherry F. Queener, Norman H. Bell

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Studies were carried out in one patient with hypoparathyroidism (HP) and in eight patients with pseudohypoparathyroidism (PHP) to determine whether the diminished clearance of phosphate could be augmented by the diuretic acetazolamide, which had been reported from other laboratories to activate renal cortical adenylate cyclase in rats and to produce phosphaturia in parathyroidectomized dogs and rats. The effects of acetazolamide, 250 or 375 mg/day for 4 days, and of parathyroid extract (PTE), 6 Units/kg body weight per day for 4 days, on serum calcium and phosphate, phosphate clearance, urinary calcium, and urinary cyclic adenosine 3′,5′-monophosphate (cyclic AMP) were compared. Whereas PTE produced significant increases in mean urinary cyclic AMP and phosphate clearance in the patient with HP, it did not increase urinary cyclic AMP and increased phosphate clearance either very little or not at all in the patients with PHP. Acetazolamide significantly increased mean phosphate clearance in all patients without changing urinary cyclic AMP. Creatinine clearance was not increased by the drug in any of the patients. The diuretic significantly increased the mean serum calcium in each of the patients with PHP and lowered the mean serum phosphate when it was abnormally elevated in all of them. Urinary calcium was not consistently altered. It is concluded that acetazolamide in man produces modest phosphaturia. This effect is apparently not mediated by cyclic AMP.

Original languageEnglish (US)
Pages (from-to)1188-1197
Number of pages10
JournalThe Journal of Laboratory and Clinical Medicine
Issue number6
StatePublished - Jun 1977

ASJC Scopus subject areas

  • Pathology and Forensic Medicine

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