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open access

Vol 74, No 5 (2023)
Review paper
Submitted: 2023-06-14
Accepted: 2023-08-31
Published online: 2023-10-23
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Secondary hyperparathyroidism in chronic kidney disease: pathomechanism and current treatment possibilities

Małgorzata Rodzoń-Norwicz12, Sebastian Norwicz3, Magdalena Sowa-Kućma1, Agnieszka Gala-Błądzińska12
DOI: 10.5603/ep.95820
·
Pubmed: 37902013
·
Endokrynol Pol 2023;74(5):490-498.
Affiliations
  1. Institute of Medical Sciences, Medical College of Rzeszow University, Rzeszow, Poland
  2. Department of Internal Medicine, Nephrology and Endocrinology, St. Queen Jadwiga Clinical District Hospital No. 2, Rzeszow, Poland
  3. Department of Nephrology and Dialysis, District Hospital John Paul II, Kolbuszowa, Poland

open access

Vol 74, No 5 (2023)
Review Article
Submitted: 2023-06-14
Accepted: 2023-08-31
Published online: 2023-10-23

Abstract

Secondary hyperparathyroidism (SHPT) is one of the most common metabolic complications resulting from chronic kidney disease (CKD). The complexity of calcium and phosphate disorders associated with CKD is defined by the Kidney Disease Improvement Global Outcomes (KDIGO) working group as CKD-related mineral and bone disorders (CKD-MBD). The last update of the KDIGO guidelines on the conduct in CKD-MBD was published in 2017. The treatment of SHPT is based on 2 strategies: counteracting hyperphosphataemia and suppressing parathyroid hormone (PTH) secretion. Therapy should be based on optimally selected drugs, taking into account additional effects to reduce the risk of chronic complications and side effects. The creation of new drugs with a better safety profile, significant reduction of side effects, and greater efficiency in achieving target serum phosphorus and PTH values forces the gradual replacement of existing treatment with new pharmacotherapies. The aim of this study is to discuss the latest issues (in connection with the latest KDIGO guidelines) regarding the pathomechanism of secondary hyperparathyroidism and the current directions of the therapy in these disorders.

Abstract

Secondary hyperparathyroidism (SHPT) is one of the most common metabolic complications resulting from chronic kidney disease (CKD). The complexity of calcium and phosphate disorders associated with CKD is defined by the Kidney Disease Improvement Global Outcomes (KDIGO) working group as CKD-related mineral and bone disorders (CKD-MBD). The last update of the KDIGO guidelines on the conduct in CKD-MBD was published in 2017. The treatment of SHPT is based on 2 strategies: counteracting hyperphosphataemia and suppressing parathyroid hormone (PTH) secretion. Therapy should be based on optimally selected drugs, taking into account additional effects to reduce the risk of chronic complications and side effects. The creation of new drugs with a better safety profile, significant reduction of side effects, and greater efficiency in achieving target serum phosphorus and PTH values forces the gradual replacement of existing treatment with new pharmacotherapies. The aim of this study is to discuss the latest issues (in connection with the latest KDIGO guidelines) regarding the pathomechanism of secondary hyperparathyroidism and the current directions of the therapy in these disorders.

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Keywords

secondary hyperparathyroidism; chronic kidney disease; calcium and phosphate balance; Klotho; FGF-23

About this article
Title

Secondary hyperparathyroidism in chronic kidney disease: pathomechanism and current treatment possibilities

Journal

Endokrynologia Polska

Issue

Vol 74, No 5 (2023)

Article type

Review paper

Pages

490-498

Published online

2023-10-23

Page views

706

Article views/downloads

723

DOI

10.5603/ep.95820

Pubmed

37902013

Bibliographic record

Endokrynol Pol 2023;74(5):490-498.

Keywords

secondary hyperparathyroidism
chronic kidney disease
calcium and phosphate balance
Klotho
FGF-23

Authors

Małgorzata Rodzoń-Norwicz
Sebastian Norwicz
Magdalena Sowa-Kućma
Agnieszka Gala-Błądzińska

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