CIN '2007 - 4o CONGRESSO DE NEFROLOGIA NA INTERNET
Mechanisms of Parathyroid Hyperplasia in Renal Failure
Dr Mario Cozzolino
Renal Division, San Paolo Hospital, University of Milan -
Abstract
In chronic kidney disease (CKD) patients, secondary hyperparathyroidism (SHPT) is characterized by parathyroid (PT) hyperplasia and enhanced synthesis and secretion of PT hormone (PTH). Elevated PTH levels cause renal osteodystrophy and cardiovascular complications, with significant increased morbidity and mortality in renal failure. The three main direct causes of SHPT are hypocalcemia, hyperphosphatemia, and vitamin D deficiency (Figure 1). A link between the mechanisms controlling proliferation and hormonal production also exists in normal parathyroid cells, which respond to the stimulus of chronic hypocalcemia, not only by an increase in PTH release but also with a consequent PT cell proliferation. Which are the mechanisms responsible for this link?Comments: