RT Generic
T1 Hyporesponsiveness or resistance to the action of parathyroid hormone in chronic kidney disease
A1 Bover, Jordi
A1 Arana, Carolt
A1 Urena, Pablo
A1 Torres, Armando
A1 Martin-Malo, Alejandro
A1 Fayos, Leonor
A1 Coll, Veronica
A1 Jesus Lloret, Maria
A1 Ochoa, Jackson
A1 Almaden, Yolanda
A1 Guirado, Lluis
A1 Rodriguez, Mariano
K1 Parathyroid hormone
K1 Parathyroid hormone receptor
K1 Chronic kidney disease-mineral and bone disorder
K1 Secondary hyperparathyroidism
K1 Parathyroid hormone resistance
K1 Phosphate
K1 Calcium
K1 Calcaemic response
K1 Calcium-sensing receptor
K1 Abnormal skeletal response
K1 Adynamic bone-disease
K1 Chronic-renal-failure
K1 Pth-pthrp receptor
K1 Secondary hyperparathyroidism
K1 Calcemic response
K1 Circulating levels
K1 Cardiovascular calcifications
K1 Dialysis patients
AB Secondary hyperparathyroidism (SHPT) is an integral component of the chronic kidney disease-mineral and bone disorder (CKD-MBD). Many factors have been associated with the development and progression of SHPT but the presence of skeletal or calcemic resistance to the action of PTH in CKD has often gone unnoticed. The term hyporesponsiveness to PTH is currently preferred and, in this chapter, we will not only review the scientific timeline but also some of the molecular mechanisms behind. Moreover, the presence of resistance to the biological action of PTH is not unique in CKD since resistance to other hormones has also been described ("uremia as a receptor disease"). This hyporesponsiveness carries out important clinical implications since it explains, at least partially, not only the progressive nature of the pathogenesis of CKD-related PTH hypersecretion and parathyroid hyperplasia but also the increasing prevalence of adynamic bone disease in the CKD population. Therefore, we underline the importance of PTH control in all CKD stages, but not aiming to completely normalize PTH levels since a certain degree of SHPT may represent an adaptive clinical response. Future studies at the molecular level, i.e. on uremia or the recent description of the calcium-sensing receptor as a phosphate sensor, may become of great value beyond their significance to explain just the hyporesponsiveness to PTH in CKD. (C) 2021 Sociedad Espanola de Nefrologia. Published by Elsevier Espana, S.L.U.
PB Soc espanola nefrologia dr rafael matesanz
SN 0211-6995
YR 2021
FD 2021-09-01
LK https://hdl.handle.net/10668/25821
UL https://hdl.handle.net/10668/25821
LA en
DS RISalud
RD Apr 8, 2025