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<p>Secondary hyperparathyroidism (sHPT) is in the beginning an adaptive reaction and later often a maladaptive complication of chronic progressive renal dysfunction up to the dialysis stage. The sHPT is primarily triggered by a&#xa0;suppressed renal vitamin&#xa0;D activation, subsequent hypocalcemia and hyperphosphatemia. A&#xa0;disproportionally increased bone turnover and progressive bone resorption increase the fracture risk of affected patients. The preventive treatment of patients with chronic kidney disease (CKD) specifically aims at a&#xa0;stage-directed restoration of vitamin&#xa0;D availability in CKD stages 3–5; however, always considering the calcium and phosphate serum levels. In the dialysis stage (CKD stage 5D), calcimimetics represent an additional and effective treatment option. The aims of treatment are maintenance of a&#xa0;normal bone turnover and avoidance of uncontrolled electrolyte disturbances, such as hypercalcemia and hyperphosphatemia, which may in turn cause cardiovascular risks.</p>

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Sekundärer Hyperparathyreoidismus

  • 期刊论文

  • 发表日期：

    2025年1月10日

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  • Markus Ketteler

摘要

Secondary hyperparathyroidism (sHPT) is in the beginning an adaptive reaction and later often a maladaptive complication of chronic progressive renal dysfunction up to the dialysis stage. The sHPT is primarily triggered by a suppressed renal vitamin D activation, subsequent hypocalcemia and hyperphosphatemia. A disproportionally increased bone turnover and progressive bone resorption increase the fracture risk of affected patients. The preventive treatment of patients with chronic kidney disease (CKD) specifically aims at a stage-directed restoration of vitamin D availability in CKD stages 3–5; however, always considering the calcium and phosphate serum levels. In the dialysis stage (CKD stage 5D), calcimimetics represent an additional and effective treatment option. The aims of treatment are maintenance of a normal bone turnover and avoidance of uncontrolled electrolyte disturbances, such as hypercalcemia and hyperphosphatemia, which may in turn cause cardiovascular risks.