Clin Osteol 2003; 8(4): 115-118

Secondary hyperparathyroidism - ongoing topical problem of chronic nephropathiesArticles

I. Sotorník, P. Bubeníček, L. Karasová, M. Adamec, M. Kouba, C. Povýšil

1. In chronic dialysis, hyperparathyroidism remains the most significant disorder of bone metabolism.
2. Its development is essentially due to a deficiency of 1,25-dihydroxyvitamin D3 and hyperphosphataemia.
3. In the context of the discussed issue, calcification and ossification changes in the smooth-muscle cells of the vascular tunica media is a major factor involved in the mortality of dialysed patients.
4. Osteoprotegerin as a new regulatory factor has a role not only in regulating the degree of bone turnover, but most probably also in the development of vascular calcifications.
5. The preservation of normocalcaemia and normophosphataemia calls for great caution in the conservative treatment of hyperparathyroidism.
6. Until perspective drugs (calcimimetics, new vitamin D3 analogues) find their way into clinical practice, parathyroidectomy will remain a necessary therapeutic intervention.

Keywords: hyperparatyreóza, chronická hemodialýza, deficit kalcitriolu, hyperfosfatémie, cévní kalcifikaceosteoprotegerin, paratyreoidek­ tomie. nephropathies

Published: December 11, 2003  Show citation