Regulation of parathyroid function in chronic renal failure.
This review summarizes the factors involved in the development of hyperparathyroidism secondary (2nd-HPTH) to chronic kidney disease (CKD). Calcium and calcitriol act on their respective specific parathyroid cell receptors to inhibit parathyroid function. As well as the well-known effect of calcium and calcitriol on parathyroid cell function, there is experimental work that demonstrates that phosphate, changes in pH, PTHrP, estrogens, and some cytokines also have an effect on PTH secretion. These factors are relevant in patients with chronic kidney disease. However, low calcium, vitamin D deficiency, and an accumulation of phosphate due to the decrease in renal function are the main pathogenic factors involved in the pathogenesis of 2nd-HPTH in CKD patients.
Rodriguez
Mariano
M
Nephrology Service, Research Unit, Hospital Reina Sofia, Department of Medicine, Veterinary School, University of Cordoba, Cordoba, Spain. juanm.rodriguez.sspa@juntadeandalucia.es
Cañadillas
Sagrario
S
Lopez
Ignacio
I
Aguilera-Tejero
Escolástico
E
Almaden
Yolanda
Y
D000138:Acidosis; D000199:Actins / Q000737:chemistry; D002117:Calcitriol / Q000378:metabolism; D002118:Calcium / Q000378:metabolism; D004305:Dose-Response Relationship, Drug; D004967:Estrogens / Q000378:metabolism; D005786:Gene Expression Regulation; D006801:Humans; D006863:Hydrogen-Ion Concentration; D006961:Hyperparathyroidism / Q000378:metabolism; D007676:Kidney Failure, Chronic / Q000378:metabolism* / Q000473:pathology*; D010280:Parathyroid Glands / Q000378:metabolism / Q000502:physiology*; D010281:Parathyroid Hormone / Q000031:analogs & derivatives / Q000378:metabolism; D010710:Phosphates / Q000378:metabolism; D012333:RNA, Messenger / Q000378:metabolism; D018167:Receptors, Calcitriol / Q000378:metabolism; D015854:Up-Regulation; D014807:Vitamin D / Q000378:metabolism; D014808:Vitamin D Deficiency
D000199:Actins; D004967:Estrogens; C470125:PTH protein, human; D010281:Parathyroid Hormone; D010710:Phosphates; D012333:RNA, Messenger; D018167:Receptors, Calcitriol; D014807:Vitamin D; D002117:Calcitriol; D002118:Calcium