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New Concepts for Primary and Secondary Hyperparathyroidism

  • Joachim Beige
  • Peter Lamesch
Chapter

Abstract

Primary hyperparathyroidism and secondary disease from chronic kidney disease are highlighted in this chapter. Up-to-date descriptions of new pathological mechanisms focus on fibroblastic growth factor 23 and its emergent importance in overall pathology. Historical, clinical, and examination findings are highlighted and compliment data on laboratory techniques, diagnostic imaging, and skeletal histology clinical workup of the patients. Treatment options at the dialysis and pharmacological levels are blended with some of the nutritional elements in phosphorus control. The integration of all elements is summarized at the end of the section to emphasize its influence on bone metabolism.

Keywords

Primary hyperparathyroidism Insulinoma Gastrinoma Pheochromocytoma Hypercalcemia RET HRPT2 Renal function 1,25 (OH)2 vitamin D Glomerular filtration Homeostasis J-shaped curve Chronic kidney disease FGF 23 Vitamin D receptor RANK ligand Osteoclastogenesis Renal osteodystrophy Calciphylaxis Fetuin GLA protein Epitopes Serum calculation Ostase (bone alkaline phosphatase) TRAP-5b Osteitits fibrosa Parathyroidectomy Calcimimetics Ca × P product Randomized controlled trial Vascular calcification Venous sampling Parathyroid scanning Oxyphilic cells Neoplasia Osteoprotegerin Sodium thiosulfate Sestamibi Technetium 99m Osteoclasts Osteoblasts Trabecular 

Notes

Acknowledgments

The authors want to thank Dr. Gabriele Lehmann (Jena), for critical review of the bone section and gratification of histological pictures as well as Andreas Plötner, MD (Leipzig), for gratification of Fig. 5.1.

My wife (J.B.), Karin Kaori Beige, bolstered this work by fine grasp and patience.

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© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  1. 1.Department of Nephrology and KfH Renal UnitHospital St. GeorgLeipzigGermany
  2. 2.Department of Endocrinological SurgeryHospital St. GeorgLeipzigGermany

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