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REVIEW ARTICLE
Year : 2019  |  Volume : 23  |  Issue : 4  |  Page : 391-399

Secondary and tertiary hyperparathyroidism in chronic kidney disease: An endocrine and renal perspective


1 Department of Endocrinology, Osteoporosis and Bone Metabolism Unit, Singapore General Hospital, Singapore
2 Department of Renal Medicine, Singapore General Hospital, Singapore

Correspondence Address:
Manju Chandran
Department of Endocrinology, Osteoporosis and Bone Metabolism Unit, Singapore General Hospital, 20 College Road, Academia, 169856
Singapore
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijem.IJEM_292_19

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Secondary Hyperparathyroidism (SHP) seen as a frequent complication in Chronic Kidney Disease (CKD) has many pathogenetic peculiarities that are still incompletely defined and understood. During the long course of chronic renal failure, SHP can also transform sometimes into the hypercalcemic state characterized by quasi-autonomous production of Parathyroid Hormone from the parathyroid glands: a disorder that is termed Tertiary Hyperparathyroidism. The clinical consequences of SHP in CKD are protean, encompassing bone and mineral abnormalities but as recently identified, also several metabolic and cardiovascular problems, the most important of which is vascular calcification. There have been several advances in the therapeutic armamentarium available for the treatment of SHP, though clear demonstration of a benefit regarding major clinical outcomes with any of the new agents is still lacking. This narrative review summarizes the current understanding about this disorder and highlights some of the recent research on the subject.


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