Pediatric Nephrology

, Volume 10, Issue 3, pp 348–350 | Cite as

Abnormal skeletal response to parathyroid hormone and the expression of its receptor in chronic uremia

  • Tilman B. Drüeke
Review Article

Abstract

Chronic renal failure is characterized by a resistance to the hypercalcemic action of parathyroid hormone (PTH). This resistance probably involves several mechanisms, including a disturbance of vitamin D metabolism, a desensitization of the skeleton by high PTH levels, hyperphosphatemia, uremic toxins, and acidosis. We have explored the possibility that a downregulation of the recently cloned PTH/PTHrp receptor might also be involved. We found a marked decrease in the expression of the receptor mRNA in the kidney and the bone of uremic rats; other authors have found a decrease in the heart and the liver. The reduced expression in the kidney was accompanied by a diminished stimulability of renal adenylate cyclase activity, suggestive of a functional depression of the hormonal response in this target tissue. It is probable that the downregulation of the PTH/PTHrp receptor plays an important role in the skeletal resistance to the calcemic effect of PTH in chronic renal failure.

key words

Hyperparathyroidism Parathyroid hormone Skeletal resistance Parathyroid hormone receptor Renal failure 

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Copyright information

© IPNA 1996

Authors and Affiliations

  • Tilman B. Drüeke
    • 1
  1. 1.INSERM Unité 90 and Département de NéphrologieHôpital NeckerParis Cedex 15France

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