Metabolic bone disease in patients receiving long-term total parenteral nutrition Academic Article uri icon


MeSH Major

  • Bone Diseases, Metabolic
  • Parenteral Nutrition
  • Parenteral Nutrition, Total


  • We have prospectively investigated calcium and bone metabolism in 16 patients receiving total parenteral nutrition for periods ranging from 7 to 89 months. In 12 patients, bone biopsies at 6 to 73 months after the start of parenteral nutrition showed osteomalacia. Plasma 25-hydroxyvitamin D levels were normal in all patients. Seven persons developed hypercalcemia, and 10 had hypercalciuria with a negative calcium balance. Serum phosphorus was normal and plasma parathyroid hormone level, normal or decreased. Three patients with the severest form of the disease had vitamin D withdrawn from their solutions. Subsequently, urinary calcium decreased, and serum calcium became normal; two persons reverted to a positive calcium balance. Thus, patients receiving total parenteral nutrition may develop metabolic bone disease characterized by osteomalacia, hypercalcemia, hypercalciuria, and a negative calcium balance. This may be caused by both defective mineralization and increased bone resorption induced by vitamin D, its metabolites, or another unrecognized factor.

publication date

  • June 20, 1980



  • Academic Article



  • eng

PubMed ID

  • 6766694

Additional Document Info

start page

  • 343

end page

  • 50


  • 92


  • 3