Korean Journal of Nephrology 1985;4(1):78-88.

만성 신부전 환자에서 Cimetidine 투여전후의 혈청 PTH치 운동신경 전도속도 및 B/S ratio의 변화에 대한 연구

윤경우 , 최수봉 , 양청헌 , 김종설 , 박충서

Abstract

Since 1980, contradictory results have been reported concerning cimetidine could inhibit seco- ndary hyperparathyroidism due to uremia. The authors therefore evaluated the effects of cimetidine, H,-receptor antagonist, on serum parathyroid hormone, motor nerve conduction velocity and B/S ratio in 10 chronic renal failure patients (9 patients on hemodialysis, 1 patient on conservative treatment). Following results were obtained. 1) Baseline serum PTH level in CRF patients (14. 66±3. 16 mIU/ml) was significantly(p<0. 01) increased compared with that of the normal con- trols(4. 20±1. 78 mIU/ml). 2) Baseline MNCV in CRF patients(39. 56 5. 66 meter/sec.) was significantly (p(0.01) decreased compared with that of the normal controls(47 4± 3. 65 meter/sec.). 3) The expected decrease in PTH level during the 10 weeks of cimetidine treatment could not be found. PTH in 4th, 6th & 10th week was 23. 73 ±18. 71 mIU/ml (p> 0. 10), 14. 954. 18 mIU/ml(p> 0. 20), 19. 68± 12. 58 mIU/ml (p>0. 10) and these were statistically not significant compared with that of the baseline (14. 66± 3. 16 mIU/ml). 4) MNCV in 6th (41.08±6.63meter/sec.) and 10th week (42. 66±5. 93 meter/sec.) were slightly increased compared with that of the baseline (39.56+5.66 meter/sec.) but these were statistica- lly not significant(p)0.20 in 6th, p)0.10 in 10 th week). 5) B/S ratio between 11th & 14th week of cimetidine treatment(6. 92± 2. 82) was slightly decreased compared with that of the baseline(7 67±3, 69), but was statistically not significant(p> 0. 20). 6) Serum calcium level during the 10th week of cimetidine treatment (7 4±0. 87 mg/dl) was sigaificantly (p<0. 05) decreased compared with that of the baseline(8. 3±1. 03 mg/dl) 7) During cimetidine treatment, 3 patients dev- eloped gynecomastia and serum prolactin levels were measured, of which one was in the normal range(16. 60ng/ml) & two were markedly elevated (154. 74 ng/ml & above 200 ng/ml) From the present study, there wasno convincing evidence that secondary hyperparathyroidism, ure- mic neuropathy and/or renal osteodystrophy could be ameliorated by of approximately 3 months duration. Cimetidine treatment However further study for an extended period of time in a large number of patients may provide us more definite answer.