Chronic Kidney Disease (CKD) associates with disturbed modulation of hormones involved in calcium and phosphate homeostasis, with development of secondary hyperparathyroidism (SHPT). SHPT includes not only divalent ions derangements, but also renal bone disease (high turnover, low turnover and/or osteomalacia) and accelerated vascular and ectopic calcifications. In this way, SHPT resembles a true clinical syndrome named CKD-MBD, which is a recognized risk factor of all-causeand cardiovascular death. Long lasting stimulation of parathyroid hormone synthesis and secretion, as observed in CKD, causes specific and progressive histological changes responsible for the development of nodular hyperplastic glands unresponsive to physiologic inhibitors and thus characterized by hypercalcemia, elevated PTH levels and resistance to the available medical therapies. In these cases, surgicalparathyroidectomy (PTX) becomes the only therapeutic option. In this chapter we review current evidence on indications, types and clinical outcomes of PTX from a practical and clinical point of view.

Parathyroidectomy in chronic kidney disease / Mazzaferro, Sandro; Rotondi, Silverio; Pasquali, Marzia; Mazzarella, Angelo; Tartaglione, Lida. - (2020), pp. 175-185. [10.1007/978-3-030-43769-5_12].

Parathyroidectomy in chronic kidney disease

Mazzaferro, Sandro;Rotondi, Silverio;Mazzarella, Angelo;Tartaglione, Lida
2020

Abstract

Chronic Kidney Disease (CKD) associates with disturbed modulation of hormones involved in calcium and phosphate homeostasis, with development of secondary hyperparathyroidism (SHPT). SHPT includes not only divalent ions derangements, but also renal bone disease (high turnover, low turnover and/or osteomalacia) and accelerated vascular and ectopic calcifications. In this way, SHPT resembles a true clinical syndrome named CKD-MBD, which is a recognized risk factor of all-causeand cardiovascular death. Long lasting stimulation of parathyroid hormone synthesis and secretion, as observed in CKD, causes specific and progressive histological changes responsible for the development of nodular hyperplastic glands unresponsive to physiologic inhibitors and thus characterized by hypercalcemia, elevated PTH levels and resistance to the available medical therapies. In these cases, surgicalparathyroidectomy (PTX) becomes the only therapeutic option. In this chapter we review current evidence on indications, types and clinical outcomes of PTX from a practical and clinical point of view.
2020
Parathyroid Glands in Chronic Kidney Disease
978-3-030-43768-8
978-3-030-43769-5
Secondary hyperparathyroidsm; parathyroidectomy; parathyroid glands; parathyroid hyperplasia; CKD-MBD; chronic kidney disease
02 Pubblicazione su volume::02a Capitolo o Articolo
Parathyroidectomy in chronic kidney disease / Mazzaferro, Sandro; Rotondi, Silverio; Pasquali, Marzia; Mazzarella, Angelo; Tartaglione, Lida. - (2020), pp. 175-185. [10.1007/978-3-030-43769-5_12].
File allegati a questo prodotto
File Dimensione Formato  
Mazzaferro_Parathyroidectomy_2020.pdf

solo gestori archivio

Note: Articolo completo
Tipologia: Versione editoriale (versione pubblicata con il layout dell'editore)
Licenza: Tutti i diritti riservati (All rights reserved)
Dimensione 540.94 kB
Formato Adobe PDF
540.94 kB Adobe PDF   Contatta l'autore

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/1470256
Citazioni
  • ???jsp.display-item.citation.pmc??? ND
  • Scopus ND
  • ???jsp.display-item.citation.isi??? ND
social impact