Abstract
SUMMARYA woman aged 29 years, with chronic glomerulonephritis with the early bone changes of secondary hyperparathyroidism, developed hypercalcremia and musculo‐skeletal symptoms during treatment with regular hremodialysis. The parathyroid glands were explored and showed hyperplasia with several small adenomata. Three and a half glands were excised, with cure of symptoms, and the serum calcium levels became normal.Following cadaveric renal transplantation, oliguria was present for 30 days. With the onset of good renal function, renal glycosuria, renal tubular acidosis and marked phosphaturia were observed. Renal glycosuria was transient, but tubular acidosis and increased phosphate clearances have persisted for more than one year. Signs and symptoms of osteodystrophy were aggravated after the onset of good renal function but responded to treatment with oral phosphate.The phosphaturia is believed to be due to continued parathyroid overactivity together with proximal renal tubular dysfunction due to ischæmia, possibly aggravated by azathioprine therapy.
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