Kidney and Metabolic Bone Diseases Vol.15 No.2(2)

Theme Intervention of parathyroid
Title Treatment of parathyroid gland hyperfunction in secondary hyperparathyroidism: atheorical mechanism
Publish Date 2002/04
Author Masanori Tokumoto The Kidney Care Unit, Kyushu University Hospital
Author Hideki Hirakata The Kidney Care Unit, Kyushu University Hospital
[ Summary ] It is well known that calcium and 1,25(OH)2 vitamin D3 negatively regulate both the synthesis and secretion of parathyroid hormone. Recent works have revealed that these factors also modulate parathyroid cell proliferation through receptors, such as calcium sensing receptor, and vitamin D receptor, being down-regulated in secondary hyperparathyroidism. Elucidating the linkage between these receptor abnormalities and parathyroid gland hyperfunction may lead to better treatment of secondary hyperparathyroidism in patients with chronic renal failure. Herein, we review how newly-developed treatment modalities for secondary hyperparathyroidism, such as perctaneous ethanol injection therapy, 1,25(OH)2 vitamin D3 direct injection therapy, use of calcimimetics and 1,25(OH)2 vitamin D3 analogs, seem promising in the inhibition of both the synthesis and secretion of parathyroid hormone as well as parathyroid cell proliferation.
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