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A more important effect of PTH on the kidney is, however, its inhibition of the reabsorption of phosphate (HPO 4 2−) from the tubular fluid, resulting in a decrease in the plasma phosphate concentration. Phosphate ions form water-insoluble salts with calcium.
PTH normally inhibits reabsorption of phosphate by the kidney. Therefore, without enough PTH there is more reabsorption of the phosphate leading to a high phosphate level in the blood. [citation needed] Chronic kidney failure: When the kidneys are not working well, there will be increased phosphate retention. [citation needed]
Effects of PTH on the Bones. ... [30] [31] Secondary hyperparathyroidism has low serum calcium and vitamin D levels, and high phosphate and PTH levels. [30] ...
Parathyroid hormone (also known as parathormone) is a small protein that takes part in the control of calcium and phosphate homeostasis, as well as bone physiology. Parathyroid hormone has effects antagonistic to those of calcitonin .
[note 1] However, parathyroid hormone has a greater effect on the quantity of phosphate ions (HPO 4 2−) excreted in the urine. [3] Phosphates form insoluble salts in combination with calcium ions. High concentrations of HPO 4 2− in the plasma, therefore, lower the ionized calcium level in the extra-cellular fluids. Thus, the excretion of ...
However, the main effect of PTH is to increase the rate at which the kidneys excrete inorganic phosphate (P i), the counterion of Ca 2+. The resulting decrease in serum phosphate causes hydroxyapatite (Ca 5 (PO 4) 3 OH) to dissolve out of bone, thus increasing serum calcium. PTH also stimulates the production of calcitriol (see below). [25]
The increase in activity of already existing osteoclasts is the initial effect of PTH, and begins in minutes and increases over a few hours. [4] Continued elevation of PTH levels increases the abundance of osteoclasts. This leads to a greater resorption of calcium and phosphate ions. [4]
Parathyroid hormone is responsible for the induction of increased calcium absorption in the gastrointestinal tract or gut and in the kidney. It also induces calcium and phosphate resorption from the bone by osteoclasts. [15] [11] Parathyroid hormone also plays a role in activating vitamin D from its pro form to its active form. [15]
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