Possible role of inorganic sulphate in the pathogenesis of hyperparathyroidism in chronic renal failure.

In order to investigate the role of hypersulphataemia in the development of hyperparathyroidism the blood levels of inorganic sulphate (SO4(2-)) and phosphate (HPO4(2-)) were compared with total and ionised calcium (Ca) and parathyroid hormone (PTH) in 20 patients with chronic renal failure (CRF). There was a positive correlation between plasma SO4(2-) and serum creatinine. Ionised Ca was inversely correlated with HPO4(2-), SO4(2-) and PTH, respectively. The best correlation was found between ionised Ca and the ion product of HPO4(2-) and SO4(2-). It is suggested that hypersulphataemia might be involved in the pathogenesis of secondary hyperparathyroidism and osteodystrophy in CRF by complex formation with Ca, thereby aggravating the effect of HPO4(2-) on ionised Ca and the resulting PTH stimulation.