PMID: 8967876Dec 1, 1995Paper

Molecular basis for the management of secondary hyperparathyroidism in chronic renal failure

Artificial Organs
M FukagawaK Kurokawa

Abstract

Recent clinical and experimental data suggest that the resistance of parathyroid cells to the physiological concentration of calcitriol plays an important role in the pathogenesis and the progression of secondary hyperparathyroidism in chronic renal failure. This resistance is due to the decreased density of the calcitriol receptor in parathyroid cells, which may result from impaired upregulation of calcitriol receptor. Since patients with larger parathyroid glands were more resistance to calcitriol pulse therapy than those with smaller glands and calcitriol receptor density inversely correlated with gland weight, the size of the parathyroid gland may serve as a marker for the degree of resistance to calcitriol. Furthermore, the possible role of phosphorus in the control of parathyroid function has been suggested recently. Thus, it is most important to prevent the progression of parathyroid hyperplasia in chronic renal failure by the early use of active vitamin D, calcitriol pulse therapy, and dietary phosphorus restriction.

References

May 1, 1991·Kidney International·M FukagawaK Kurokawa
Oct 1, 1990·The Journal of Clinical Investigation·T Naveh-Many, J Silver
Aug 9, 1990·The New England Journal of Medicine·M FukagawaK Kurokawa
Jul 1, 1993·Current Opinion in Nephrology and Hypertension·T AkizawaK Kurokawa
Apr 15, 1993·Nature

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Citations

Nov 21, 2012·Archivos de cardiología de México·Rafael González-Toledo, Martha Franco

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