A New Paradigm for the Treatment of Secondary Hyperparathyroidism
نویسندگان
چکیده
The global rise in chronic kidney disease makes secondary hyperparathyroidism (SHPT) a growing medical concern. Conventional therapies for treating SHPT are limited and include calcium-based and calcium-free phosphate binders for reducing serum phosphorus and vitamin D or its analogues for simultaneous stimulation of calcium absorption and suppression of parathyroid hormone (PTH) gene expression. Control of SHPT using these therapies has typically been poor. Recent studies have demonstrated that use of calcimimetics that reduce PTH secretion by increasing the sensitivity of the parathyroid gland calcium-sensing receptor to circulating calcium allow improved control of serum PTH, calcium, phosphorus and calcium-phosphorus product. This review describes experimental data and the clinical rationale supporting novel strategies for the integration of calcimimetics with conventional therapies to improve control of SHPT.
منابع مشابه
The role of secondary hyperparathyroidism in anemia of end stage renal disease
Introduction: secondary hyperparathyroidism is listed among the possible reasons for intensifying the anemia and resistance to erythropoietin therapy in hemodialysis patients. Although its exact mechanism is not entirely clarified, but shift of bone marrow cells to adipocytes, bone marrow fibrosis and decreased calciteriol can be the causes. However, the role of secondary hyperparathyroidism in...
متن کاملSagliker Syndrome in a Patient with Secondary Hyperparathyroidism and Chronic Renal Insufficiency: A Case Report
Sagliker syndrome is a rare form of renal osteodystrophy resulted from untreated secondary hyperparathyroidism. It is described by severe skeletal deformities, high level of PTH in patients with chronic renal failure, and deformed face. This paper reports a 44-year-old male patient with the mentioned characteristics. In addition to the unique clinical features, high levels of ALP and PTH hormon...
متن کاملVitamin D deficiency and secondary hyperparathyroidism in pediatrics obesity
Obesity is one of the health problems in the developing and developed countries. Obesity subjects the individuals with metabolic and endocrine disorders. It is obvious that vitamin D deficiency or insufficiency may lead to secondary hyperparathyroidism. Thus, obesity increases the risk of vitamin D deficiency. Considering the high prevalence of vitamin D deficiency in children and adolescents w...
متن کاملLiterature review in the treatment of calciphylaxis:A case with uncontrolled and severe secondary hyperparathyroidism
Background: Calciphylaxis is a serious disorder often observed in dialysis patients and less frequently in chronic renal failure patients with secondary hyperparathyroidism. Mortality rate increases following the development of calciphylaxis, immediate application of parathyroidectomy along with other treatment options may be lifesaving. Case Presentation: A 44-year-old male patient had been...
متن کاملIntensification of Anemia by Secondary Hyperparathyroidism in Hemodialysis Patients
The excessive amounts of parathyroid hormone in secondary hyperparathyroidism (SHPTH) is suggested to interfere with normal erythropoiesis. In SHPTH, during chronic renal failure, due to the impairment of erythropoietin synthesis, this effect is more pronounced. In the present study the role of secondary hyperparathyroidism in the severity of anemia was evaluated in hemodialysis patients (n=3...
متن کاملMinimally invasive radio-guided surgery for hyperparathyroidism: an experience with Tc-99m Sestamibi
Introduction: Radio-guided parathyroid surgery along with other minimally invasive surgeries constitutes the main surgical treatment procedures for different kinds of hyperparathyroidism. In this article we have reported our experience of radio-guided parathyroid surgery using Tc-99m sestamibi. Methods: Ten patients with hyperparathyroidism included in our study. ...
متن کامل