SECONDARY AND TERTIARY HYPERPARATHYROIDSIS IN CHRONIC KIDNEY DISEASE
Abstract
Treatment goals for secondary hyperparathyroidism in patients with chronic kidney disease are aimed at preventing disease progression and suppressing parathyroid activity through modulation of vitamin D receptors and calcium-sensing receptors. However, treatment options are limited in severe hyperparathyroidism; monoclonal changes and nodular transformation of glands with loss of receptors for vitamin D and calcium form resistance to this therapy with the development of drug-uncontrolled hyperparathyroidism.
Keywords
Clinical case; secondary hyperparathyroidism; tertiary hyperparathyroidism; cinacalcet; parathyroidectomy; hemodialysis; kidney transplant.
References
- Abe M, Okada K, Soma M. Mineral Metabolic Abnormalities and Mortality in Dialysis Patients. Nutrients. 2013;5(3):1002-1023. doi: 10.3390/nu5031002.
- Goodman WG, Quarles LD. Development and progression of secondary hyperparathyroidism in chronic kidney disease:
- lessons from molecular genetics. Kidney Int. 2018;74(3):276-288. doi: 10.1038/sj.ki.5002287.
- Chertow GM, Dillon M, Burke SK, et al. A randomized trial of sevelam-er hydrochloride (RenaGel) with and without supplemental calcium. Strategies for the control of hyperphosphatemia and hyperparathyroidism in hemodialysis patients. Clin Nephrol. 2019;51(1):18-26.
- Chertow GM, Lu ZJ, Xu X, et al. Self-reported symptoms in patients on hemodialysis with moderate to severe secondary hyperparathyroidism receiving combined therapy with cinacalcet and low-dose vitamin D sterols. Hemodialysis International. 2012;16(2):188-197. doi: 10.1111/j.1542-4758.2011.00642.x.
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