[Renal bone disease and osteoprotegerin].
The skeletal resistance to PTH is a phenomenon specifically found in uremia. The skeletal resistance to PTH appears as an anti-calcemic effect against exogenous PTH load in the physiological aspect, and as the discrepancy between serum PTH level and bone turnover in the morphological aspect. Therefore, it can be a common pathogenesis of both secondary hyperparathyroidism and adynamic bone. Osteoprotegerin, a newly found osteoclastogenesis inhibitory factor, may be one of such uremic toxins that promote the skeletal resistance to PTH in uremia. However, the mechanism why circulating osteoprotegerin level is elevated remains unknown.
Kazama
Junichiro James
JJ
Division of Intensive Care Medicine, Niigata University Medical Hospital.