Novel insights into parathyroid hormone: report of The Parathyroid Day in Chronic Kidney Disease

Abstract Chronic kidney disease (CKD) is often associated with a mineral and bone disorder globally described as CKD-Mineral and Bone Disease (MBD), including renal osteodystrophy, the latter ranging from high bone turnover, as in case of secondary hyperparathyroidism (SHPT), to low bone turnover. T...

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Veröffentlicht in:Clinical Kidney Journal 2019-04, Vol.12 (2), p.269-280
Hauptverfasser: Ureña-Torres, Pablo A, Vervloet, Marc, Mazzaferro, Sandro, Oury, Franck, Brandenburg, Vincent, Bover, Jordi, Cavalier, Etienne, Cohen-Solal, Martine, Covic, Adrian, Drüeke, Tilman B, Hindié, Elif, Evenepoel, Pieter, Frazão, João, Goldsmith, David, Kazama, Junichiro James, Cozzolino, Mario, Massy, Ziad A
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container_issue 2
container_start_page 269
container_title Clinical Kidney Journal
container_volume 12
creator Ureña-Torres, Pablo A
Vervloet, Marc
Mazzaferro, Sandro
Oury, Franck
Brandenburg, Vincent
Bover, Jordi
Cavalier, Etienne
Cohen-Solal, Martine
Covic, Adrian
Drüeke, Tilman B
Hindié, Elif
Evenepoel, Pieter
Frazão, João
Goldsmith, David
Kazama, Junichiro James
Cozzolino, Mario
Massy, Ziad A
description Abstract Chronic kidney disease (CKD) is often associated with a mineral and bone disorder globally described as CKD-Mineral and Bone Disease (MBD), including renal osteodystrophy, the latter ranging from high bone turnover, as in case of secondary hyperparathyroidism (SHPT), to low bone turnover. The present article summarizes the important subjects that were covered during 'The Parathyroid Day in Chronic Kidney Disease' CME course organized in Paris in September 2017. It includes the latest insights on parathyroid gland growth, parathyroid hormone (PTH) synthesis, secretion and regulation by the calcium-sensing receptor, vitamin D receptor and fibroblast growth factor 23 (FGF23)-Klotho axis, as well as on parathyroid glands imaging. The skeletal action of PTH in early CKD stages to the steadily increasing activation of the often downregulated PTH receptor type 1 has been critically reviewed, emphasizing that therapeutic strategies to decrease PTH levels at these stages might not be recommended. The effects of PTH on the central nervous system, in particular cognitive functions, and on the cardiovascular system are revised, and the reliability and exchangeability of second- and third-generation PTH immunoassays discussed. The article also reviews the different circulating biomarkers used for the diagnosis and monitoring of CKD-MBD, including PTH and alkaline phosphatases isoforms. Moreover, it presents an update on the control of SHPT by vitamin D compounds, old and new calcimimetics, and parathyroidectomy. Finally, it covers the latest insights on the persistence and de novo occurrence of SHPT in renal transplant recipients.
doi_str_mv 10.1093/ckj/sfy061
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The present article summarizes the important subjects that were covered during 'The Parathyroid Day in Chronic Kidney Disease' CME course organized in Paris in September 2017. It includes the latest insights on parathyroid gland growth, parathyroid hormone (PTH) synthesis, secretion and regulation by the calcium-sensing receptor, vitamin D receptor and fibroblast growth factor 23 (FGF23)-Klotho axis, as well as on parathyroid glands imaging. The skeletal action of PTH in early CKD stages to the steadily increasing activation of the often downregulated PTH receptor type 1 has been critically reviewed, emphasizing that therapeutic strategies to decrease PTH levels at these stages might not be recommended. The effects of PTH on the central nervous system, in particular cognitive functions, and on the cardiovascular system are revised, and the reliability and exchangeability of second- and third-generation PTH immunoassays discussed. The article also reviews the different circulating biomarkers used for the diagnosis and monitoring of CKD-MBD, including PTH and alkaline phosphatases isoforms. Moreover, it presents an update on the control of SHPT by vitamin D compounds, old and new calcimimetics, and parathyroidectomy. 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subjects Biological markers
calcium
Central nervous system
Chronic kidney failure
CKD
CKD-Mbd
Diseases
EDTA
Fibroblast growth factors
Health aspects
Hormones
Human health sciences
Hyperparathyroidism
Kidney diseases
Laboratory medicine & medical technology
Médecine de laboratoire & technologie médicale
Organ transplant recipients
Parathyroid hormones
phosphataemia
Phosphatases
Physiological aspects
Sciences de la santé humaine
Urologie & néphrologie
Urology & nephrology
Vitamin D
Vitamins
title Novel insights into parathyroid hormone: report of The Parathyroid Day in Chronic Kidney Disease
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