Secondary Hyperparathyroidism in End-Stage Renal Disease: No Longer a Matter for Surgeons?

Mario Cozzolino, Francesca Elli, Stefano Carugo, Paola Ciceri

Research output: Contribution to journalReview articlepeer-review


Hyperphosphatemia, hypocalcemia and vitamin D deficiency are the main factors involved in the pathogenesis of secondary hyperparathyroidism (SHPT). Moreover, the skeletal resistance to parathyroid hormone is not only a high-turnover bone accompanying SHPT, but may also play a crucial role in the onset of low-turnover bone disease in uremia. However, a growing body of evidence suggests that other hormones play a key role in this disease, such as fibroblast growth factor 23, Klotho and sclerostin. SHPT causes both bone-associated and non-skeletal consequences, including cardiovascular calcifications. Furthermore, vitamin D and calcium (Ca)-containing phosphate binders may increase Ca load. Anyway, the rate of parathyroidectomy in end-stage renal disease has greatly decreased during the last decade. Is there any room left for surgeons?

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Original languageEnglish
Pages (from-to)44-48
Number of pages5
JournalBlood Purification
Issue number1
Publication statusPublished - Jun 1 2016


  • Chronic kidney disease
  • Chronic kidney disease-mineral bone disorder
  • Dialysis
  • Parathyroid hormone
  • Secondary hyperparathyroidism

ASJC Scopus subject areas

  • Nephrology
  • Hematology


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