Secondary Hyperparathyroidism: Pathophysiology and Treatment

Saliba, Wissam; El-Haddad, Boutros

doi:10.3122/jabfm.2009.05.090026

Cited by 100 publications

(83 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The number and size of lesions correlate with the serum phosphate level. Dietary phosphate restriction, phosphate binders, and if necessary in patients with elevated iPTH levels, parathyriodectomy may help lower serum phosphate levels (65)(66)(67). Lesions tend to regress after the hyperphosphatemia resolves (66).…”

Section: Metastatic Calcificationmentioning

confidence: 99%

See 1 more Smart Citation

Cutaneous Manifestations of ESRD

Galperin

Cronin

Leslie

2014

Clinical Journal of the American Society of Nephrology

193

View full text Add to dashboard Cite

SummaryA broad range of skin diseases occurs in patients with ESRD: from the benign and asymptomatic to the physically disabling and life-threatening. Many of them negatively impact on quality of life. Their early recognition and treatment are essential in reducing morbidity and mortality. The cutaneous manifestations can be divided into two main categories: nonspecific and specific. The nonspecific manifestations are commonly seen and include skin color changes, xerosis, half-and-half nails, and pruritus. The specific disorders include acquired perforating dermatosis, bullous dermatoses, metastatic calcification, and nephrogenic systemic fibrosis. This review article describes these conditions and considers the underlying pathophysiology, clinical presentations, diagnosis, and treatment options.

show abstract

Section: Metastatic Calcificationmentioning

confidence: 99%

“…Secondary hyperparathyroidism, with increased levels of intact parathyroid hormone (iPTH), mobilizes the release of calcium and phosphate from the bone into the serum. When the levels of serum calcium and phosphate reach a solubility threshold, calcinosis cutis can occur (65,66).…”

Section: Metastatic Calcificationmentioning

confidence: 99%

Cutaneous Manifestations of ESRD

Galperin

Cronin

Leslie

2014

Clinical Journal of the American Society of Nephrology

193

View full text Add to dashboard Cite

show abstract

“…Hyperphosphataemia is an effect of a decreased glomerular filtration rate, and secondary hyperparathyroidism together with its associated increase in parathormone concentration contribute to the resorption of calcium and phosphates from bones [2,6,24]. As soon as their plasma solubility threshold is exceeded, calcium deposits begin to form in the skin, with a potential to evacuate spontaneously without accompanying tissue necrosis [2,3,6,24]. The clinical features include white papules and nodules on the skin over the joints and on the palmar surfaces of the fingers [2,3,6,17].…”

Section: Calcinosismentioning

confidence: 99%

“…The severity of calcifications is positively correlated with increasing plasma levels of phosphates, and they have a tendency to regress along with decreases in phosphate concentrations. Patients are advised to follow a diet with a limited intake of phosphate-rich foods and use supplements binding the compounds in the gastrointestinal tract [2,6,24].…”

Section: Calcinosismentioning

confidence: 99%

Skin changes in chronic kidney disease

Przepiórka-Kosińska¹,

Chyl-Surdacka²,

Bartosińska³

et al. 2017

View full text Add to dashboard Cite

Chronic kidney disease causes skin changes which may sometimes be the first sign of kidney failure. Specific skin changes include acquired perforating dermatosis, porphyria cutanea tarda, pseudoporphyria, calcinosis and nephrogenic systemic fibrosis. The majority of patients present with cutaneous manifestations which are classified as nonspecific, including xerosis, pruritus, pigmentation disturbances, nail plate abnormalities, uraemic frost and gynaecomastia. Treatment improving kidney function (dialysis therapy or kidney transplantation) also leads to the resolution of skin lesions. STRESZCZENIEPrzewlekła choroba nerek powoduje zmiany skórne, które niejednokrotnie mogą być pierwszym objawem niewydolności nerek. Do swoistych zmian skórnych należą: nabyta perforująca dermatoza, porfiria skórna późna, pseudoporfiria, zwapnienia oraz uogólnione nerkopochodne włóknienie. Zmiany zaliczane do objawów nieswoistych, takie jak suchość skóry, świąd skóry, zmiany jej zabarwienia, nieprawidłowości dotyczące płytek paznokciowych, szron mocznicowy oraz ginekomastia, są spotykane u większości pacjentów. Leczenie powodujące poprawę wydolności nerek (dializoterapia lub przeszczepienie nerki) prowadzi jednocześnie do złagodzenia lub ustąpienia objawów skórnych.

show abstract

“…Secondary hyperparathyroidism (SHPT) is an abnormal condition commonly observed in CKD patients [4]. Elevated serum PTH and its peptide fragments concentrations adversely affect bone metabolism.…”

Section: Introductionmentioning

confidence: 99%

Stężenia parathormonu w surowicy oznaczane metodą chemiluminescencji i elektrochemiluminescencji — czy wyniki są porównywalne u hemodializowanych chorych na przewlekłą chorobę nerek?

Kuczera

Maszczyk

Machura

et al. 2015

Endokrynologia Polska

View full text Add to dashboard Cite

Introduction: Secondary hyperparathyroidism (sHPT) is one of the most common abnormalities found in patients with chronic kidney disease (CKD). Measurement of serum PTH concentrations is crucial in diagnosis and treatment of sHPT. Different methods of serum PTH measurement may provide diverse results. This may have a significant impact on the therapeutic approach if under-or over-diagnosis of sHPT occurs. The aim of this study was to compare the results of serum PTH concentrations measured with two commonly used methods -chemiluminescence (CHL) and electrochemiluminescence (ECL). Material and methods: Seventy-seven haemodialysis patients with CKD were enrolled into the study. Blood samples were collected before haemodialysis, in the middle of the week. In all patients, serum PTH concentrations were measured using two methods: CHL and ECL. Results: Serum PTH concentration measured with CHL was significantly higher than that assessed with ECL: 455 pg/mL (352-559) pg/mL vs. 383 pg/mL (243-523) pg/mL; p < 0.0001. Six patients from the studied cohort were treated with cinacalcet. In these patients, the serum PTH concentration was also significantly higher when measured with CHL than with ECL: 755 pg/mL (294-1216) pg/mL and 607 pg/mL (199-1015 pg/mL); p = 0.027, respectively). In three cases serum PTH concentration assessed with CHL method exceeded 300 pg/mL, whereas when measured with ECL it was below 300 pg/mL. Lower serum PTH concentrations could give the rationale to lower cinacalcet dose or to stop such treatment. Conclusions:1. Serum PTH concentrations in haemodialysis patients with CKD measured by CHL and ECL methods differ significantly.

show abstract

Secondary Hyperparathyroidism: Pathophysiology and Treatment

Cited by 100 publications

References 27 publications

Cutaneous Manifestations of ESRD

Cutaneous Manifestations of ESRD

Skin changes in chronic kidney disease

Stężenia parathormonu w surowicy oznaczane metodą chemiluminescencji i elektrochemiluminescencji — czy wyniki są porównywalne u hemodializowanych chorych na przewlekłą chorobę nerek?

Contact Info

Product

Resources

About