Goodman WG, Belin T, Gales B, Juppner H, Segre GV, Salusky IB
Calcium-regulated parathyroid hormone release in patients with
mild or advanced secondary hyperparathyroidism
(Nov) 48:1553-1558 1995
The relative importance of parathyroid gland hyperplasia versus abnormal
calcium-regulated PTH secretion in the genesis of hyperparathyroidism in
failure is controversial although most would agree that the former plays the
predominant role. The authors studied 26 patients with bone histological
evidence of hyperparathyroidism treated with CCPD and 20 normal controls.
induced hypocalcemic PTH stimulation and hypercalcemic PTH suppression. The
set-point (using the 4 parameter model) for PTH secretion and the slope of
Ca-PTH curve was the same in the two groups. The authors divided the renal
failure patients into mild (PTH<400 pg/ml), moderate (PTH>400 but <600
and severe (PTH>600 pg/ml) hyperparathyroidism. The slopes and set-points
not differ in the three groups. The authors conclude that the degree of
parathryoid gland hyperplasia may be a more important determinant of the
severity of secondary hyperparathyroidism in patients with renal failure!
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