Secondary Hyperparathyroidism in Chronic Kidney Disease: Mechanism of Development
Keywords:
parathyroid hormone, calcium and phosphorus, the digestive tract, fat-soluble vitamins
Abstract
Secondary hyperparathyroidism (SHPT) is a condition that occurs in response to chronic hypocalcemia (low blood calcium levels) and is linked to a higher release of parathyroid hormone (PTH) by the parathyroid glands. This disease is most often a compensatory reaction of the body to calcium deficiency caused by various pathologies, especially chronic kidney disease or impaired calcium metabolism. Methods. This review article compiles existing knowledge on SHPT in CKD. The authors conducted a literature search to identify relevant studies published in peer-reviewed journals. The search strategy focused on keywords such as "secondary hyperparathyroidism," "chronic kidney disease," "calcium-phosphorus metabolism," "renal osteodystrophy," and "treatment." The retrieved articles were critically appraised to ensure their scientific merit and relevance to the topic (references to be added).
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S. Okuno, M. Inaba, E. Ishimura, et al., "Effects of long-term cinacalcet administration on parathyroid gland in hemodialysis patients with secondary hyperparathyroidism," Nephron, vol. 142, no. 2, pp. 106–113, 2019. DOI: 10.1159/000496808.
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R. Civitelli and K. Ziambaras, "Calcium and phosphate homeostasis: concerted interplay of new regulators," J. Endocrinol. Invest., vol. 34, pp. 3–7, 2011.
T. Isakova, T. L. Nickolas, M. Denburg, S. Yarlagadda, D. E. Weiner, O. M. Gutiérrez, V. Bansal, S. E. Rosas, S. Nigwekar, J. Yee, and H. Kramer, "KDOQI US Commentary on the 2017 KDIGO Clinical Practice Guideline Update for the Diagnosis, Evaluation, Prevention, and Treatment of Chronic Kidney Disease-Mineral and Bone Disorder (CKD-MBD)," Am. J. Kidney Dis., vol. 70, no. 6, pp. 737–751, 2017.
E. M. Brown and S. C. Hebert, "Calcium-receptor-regulated parathyroid and renal function," Bone, vol. 20, pp. 303–309, 1997.
E. Slatopolsky, J. Finch, M. Denda, et al., "Phosphorus restriction prevents parathyroid gland growth. High phosphorus directly stimulates PTH secretion in vitro," J. Clin. Invest., vol. 97, pp. 2534–2540, 1996.
E. Slatopolsky, A. Brown, and A. Dusso, "Role of phosphorus in the pathogenesis of secondary hyperparathyroidism," Am. J. Kidney Dis., vol. 37, pp. S54–S57, 2001. DOI: 10.1053/ajkd.2001.20740.
K. J. Martin, J. Floege, and M. Ketteler, "Bone and mineral disorders in chronic kidney disease," in Comprehensive Clinical Nephrology, 6th ed., J. Feehally, Ed. Berlin/Heidelberg, Germany: Springer, 2019.
M. T. Chakhtoura, N. N. Nakhoul, and K. Shawwa, et al., "Hypovitaminosis D in bariatric surgery: A systematic review of observational studies," Metabolism, vol. 65, no. 4, pp. 574–585, 2016. DOI: 10.1016/j.metabol.2015.12.004.
M. Johnson, J. Maher, and E. DeMaria, "The long-term effects of gastric bypass on vitamin D metabolism," Ann. Surg., vol. 243, pp. 701–705, 2006.
F. Llach, "Secondary hyperparathyroidism in renal failure: the trade-off hypothesis revisited," Am. J. Kidney Dis., vol. 25, pp. 663–679, 1995.
G. Asci, E. Ok, R. Savas, et al., "The link between bone and coronary calcifications in CKD-5 patients on haemodialysis," Nephrol. Dial. Transpl., vol. 26, pp. 1010–1015, 2011.
Y. Fang, C. Ginsberg, and M. Seifert, et al., "CKD-induced wingless/integration1 inhibitors and phosphorus cause the CKD-mineral and bone disorder," J. Am. Soc. Nephrol., vol. 25, pp. 1760–1773, 2014.
R. Agoro and K. White, "Regulation of FGF23 production and phosphate metabolism by bone-kidney interactions," Nat. Rev. Nephrol., vol. 19, no. 3, pp. 185–193, 2023.
N. Garcia-Fernandez, J. Lavilla, and P. Martín, et al., "Increased fibroblast growth factor 23 in heart failure: biomarker, mechanism, or both?," Am. J. Hypertens., vol. 32, no. 1, pp. 15–17, 2019. DOI: 10.1093/ajh/hpy153.
B. Ho and C. Bergwitz, "FGF23 signalling and physiology," J. Mol. Endocrinol., vol. 66, no. 2, pp. R23–R32, 2022. DOI: 10.1530/JME-20-0178.
M. Kuro-O, "The Klotho proteins in health and disease," Nat. Rev. Nephrol., vol. 15, pp. 27–44, 2019.
M. Kuro-O, Y. Matsumura, H. Aizawa, et al., "Mutation of the mouse klotho gene leads to a syndrome resembling ageing," Nature, vol. 390, pp. 45–51, 1997. DOI: 10.1038/36285.
T. Nakatani, B. Sarraj, M. Ohnishi, et al., "In vivo genetic evidence for klotho-dependent, fibroblast growth factor 23 (Fgf23)-mediated regulation of systemic phosphate homeostasis," FASEB J., vol. 23, pp. 433–441, 2009. DOI: 10.1096/fj.08-114397.
S. Moe, T. Drüeke, J. Cunningham, et al., "Definition, evaluation, and classification of renal osteodystrophy: A position statement from Kidney Disease: Improving Global Outcomes (KDIGO)," Kidney Int., vol. 69, no. 11, pp. 1945–1953, 2006. DOI: 10.1038/sj.ki.5000414.
S. M. Moe, "Renal osteodystrophy or kidney-induced osteoporosis?," Curr. Osteoporos. Rep., vol. 15, no. 3, pp. 194–197, 2017. DOI: 10.1007/s11914-017-0364-1.
S. M. Sprague, E. Bellorin-Font, V. Jorgetti, et al., "Diagnostic accuracy of bone turnover markers and bone histology in patients with CKD treated by dialysis," Am. J. Kidney Dis., vol. 67, no. 4, pp. 559–566, 2016.
S. Okuno, M. Inaba, E. Ishimura, et al., "Effects of long-term cinacalcet administration on parathyroid gland in hemodialysis patients with secondary hyperparathyroidism," Nephron, vol. 142, no. 2, pp. 106–113, 2019. DOI: 10.1159/000496808.
G. J. Behets, G. Spasovski, L. R. Sterling, et al., "Bone histomorphometry before and after long-term treatment with cinacalcet in dialysis patients with secondary hyperparathyroidism," Kidney Int., vol. 87, pp. 846–856, 2015. DOI: 10.1038/ki.2014.349.
Published
2025-01-07
How to Cite
Yuldasheva N.Kh., Adilova N.Sh., Kudratova N.A., Axmedova F.Sh, Artikova D.M, & Mirhaydarova F.S. (2025). Secondary Hyperparathyroidism in Chronic Kidney Disease: Mechanism of Development . Central Asian Journal of Medical and Natural Science, 6(1), 227-231. Retrieved from https://cajmns.centralasianstudies.org/index.php/CAJMNS/article/view/2690
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