Calcium Metabolism in Nephrosis. I. a Description of an Abnormality in Calcium Metabolism in Children with Nephrosis.

In 1923, not many years after Epstein's (1) original characterization of lipoid nephrosis, Salvesen and Linder (2) first observed a lowering of the serum calcium concentration which paralleled the decrease in serum protein level in patients with this disease.' In addition, two other features indicating a disturbance of calcium metabolism in nephrosis have been described. Boyd, Courtney, and MacLachan in 1926 (5) and Scriver in 1928 (6) both noted an excessive loss of calcium in the feces and a diminished excretion in the urine. In the course of a systematic study of children with nephrosis in this hospital over the past 5 years, a further indication of abnormal calcium metabolism has come to our attention, namely, a generalized decalcification of the skeleton as observed by x-ray. The degree of this decalcification varies roughly with the severity and duration of the disease; in 2 instances in our experience, fractures have occurred after relatively slight trauma. Some degree of decalcification is often demonstrable within a month after detection of the disease. The studies reported in this and a subsequent paper were designed to correlate the x-ray changes