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Early Skeletal Effect of Alkali Therapy upon the Osteomalacia of Renal Tubular Acidosis

Instituto de Investigaciones Médicas, Facultad de Medicina, Universidad de Buenos Aires Argentina

The administration of alkaline agents to a 16-year-old girl with severe renal tubular acidosis and osteomalacia caused an almost immediate rise of the urinary excretion of total hydroxyproline. The increment of the dyalizable fraction predominated over the nondyalizable component. Gradually serum phosphate and serum alkaline phosphatase increased whereas urinary calcium and magnesium and phosphate clearance declined. Serum PTH remained elevated throughout. We suggest that the correction of the metabolic acidosis might increase the transport of phosphate and calcium across the functional bone membrane leading to a rapid deposition of lime salts in the uncalcified matrix with a concomitant increase in bone collagen turnover.

¹ Present address: Unidad de Osteopatias Metabolicas, Servicio de Endocrinologia, Hospital de Clfnicas, Cordoba 2351, Buenos Aires, Argentina.

^* Research Career (CONICET, Argentina).

Received May 7, 1974.