Novel insights into parathyroid hormone: report of The Parathyroid Day in Chronic Kidney Disease
Por:
Urena-Torres, PA, Vervloet, M, Mazzaferro, S, Oury, F, Brandenburg, V, Bover, J, Cavalier, E, Cohen-Solal, M, Covic, A, Drueke, TB, Hindie, E, Evenepoel, P, Frazao, J, Goldsmith, D, Kazama, JJ, Cozzolino, M, Massy, ZA, ERA-EDTA CKD-MBD Working Grp
Publicada:
1 abr 2019
Resumen:
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.
Filiaciones:
Urena-Torres, PA:
Univ Paris 05, Dept Nephrol & Dialysis, Clin Landy, Ramsay Gen Sante, Paris, France
Univ Paris 05, Necker Hosp, Dept Renal Physiol, Paris, France
Vervloet, M:
Vrije Univ Amsterdam Med Ctr, Dept Nephrol, Amsterdam, Netherlands
Vrije Univ Amsterdam Med Ctr, ACS, Amsterdam, Netherlands
Mazzaferro, S:
Sapienza Univ Rome, Dept Cardiovasc Resp Nephrol Anaesthet & Geriatr, Rome, Italy
Oury, F:
Sorbonne Paris Cite, Fac Med Paris Descartes, Ctr Med Mol, INEM, Batiment Leriche, Paris, France
Brandenburg, V:
Univ Hosp RWTH Aachen, Dept Cardiol, Pauwelsstr, Aachen, Germany
Bover, J:
IIB St Pau, Fundacio Puigvert, Dept Nephrol, RedinRen, Barcelona 340350, Spain
Cavalier, E:
Univ Liege, CHU Sart Tilman, Dept Clin Chem, Liege, Belgium
Cohen-Solal, M:
INSERM, U1132, Paris, France
USPC Paris Diderot, Hop Lariboisiere, Dept Rheumatol, Paris, France
Covic, A:
Univ Med & Pharm Gr T Popa, Dept Nephrol, Iasi, Romania
Drueke, TB:
Hop Paul Brousse, INSERM, Unit 1018, CESP,Team 5, Villejuif, France
Hindie, E:
Univ Bordeaux, Haut Leveque Hosp, Nucl Med, Pessac, France
Evenepoel, P:
Univ Hosp Leuven, Div Nephrol, Dept Med, Leuven, Belgium
Univ Ziekenhuis Gasthuisberg, Dienst Nefrol, Herestr, Leuven, Belgium
Frazao, J:
Univ Porto, Inst Invest & Innovat Hlth, Porto, Portugal
Univ Porto, INEB, Porto, Portugal
Sao Joao Hosp Ctr, Dept Nephrol, Porto, Portugal
Univ Porto, Sch Med, Porto, Portugal
Goldsmith, D:
Guys & St Thomas Hosp, London, England
Kazama, JJ:
Fukushima Med Univ, Dept Nephrol & Hypertens, 1 Hikarigaoka, Fukushima 9601247, Japan
Cozzolino, M:
Univ Milan, Dept Hlth Sci, San Paolo Hosp, Div Renal, Milan, Italy
Massy, ZA:
Univ Paris Ouest UVSQ, Ambroise Pare Univ Med Ctr, APHP, Div Nephrol, Boulogne Billancourt, France
Gold, Green Published
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