Pathophysiology and Treatment of Secondary and Tertiary Hyperparathyroidism

Chapter

Abstract

Serum parathyroid hormone (PTH) levels start to rise once the glomerular filtration rate falls below 60 ml/min with secondary hyperparathyroidism (2HPTH), becoming an almost universal complication in dialysis dependent chronic kidney disease (CKD). A better knowledge of the biological functions of the calcium-sensing receptor (CaSR) and the vitamin D receptor (VDR), and especially the recent discovery of fibroblast growth factor 23 (FGF-23) and the elucidation of its function as a phosphaturic and 1,25(OH)2VitD counterregulatory hormone have provided a new conceptual framework for the understanding of the pathogenesis of 2HPTH.

Keywords

Chronic Kidney Disease Parathyroid Gland Parathyroid Adenoma Parathyroid Cell Bilateral Neck Exploration 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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© Springer-Verlag Berlin Heidelberg 2012

Authors and Affiliations

  1. 1.Department of SurgeryUniversity Hospital of GenevaGenevaSwitzerland
  2. 2.Division of Nephrology, Department of MedicineUniversity Clinic GasthuisbergLeuvenBelgium

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