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NDT Advance Access originally published online on November 30, 2006
Nephrology Dialysis Transplantation 2007 22(3):696-699; doi:10.1093/ndt/gfl728
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© The Author [2006]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Primary hyperparathyroidism—what the nephrologist should know—an update

Friedhelm Raue and Karin Frank-Raue

Endocrine practice, Heidelberg, Germany

Correspondence and offprint requests to: Prof. Dr Med. Friedhelm Raue, Endokrinologische Gemeinschaftspraxis, Brückenstr.21, 69120 Heidelberg, Germany. Email: friedhelm.raue@raue-endokrinologie.de

Keywords: calcium sensing receptor; familial hypocalciuric hypercalcaemia; HRPT-2 gene; MEN-1 gene; primary hyperparathyroidism; RET-gene

The first 150 words of the full text of this article appear below.



   Introduction
 
In the first 40 years, after its recognition as a clinical entity, primary hyperparathyroidism (HPT) presented as a disorder with kidney stones and bone disease. Now, HPT is often recognized as a result of biochemical screening, or as part of an evaluation for decreased bone mass [1, 2]. The diagnosis of HPT is usually made by finding an inappropriately elevated serum parathyroid hormone (PTH) concentration associated with hypercalcaemia. The current understanding of molecular mechanisms of calcium regulation by calcium-sensing receptor (CaSR) and proliferation of parathyroid cells by oncogenes (RET) and tumour suppressor genes (MEN1 gene, HRPT2 gene) has in part changed the management of HPT.



   Calcium-sensing receptor
 
Serum ionized calcium concentrations are normally maintained within the very narrow range achieved through a tightly regulated calcium-PTH homeostatic system [3]. PTH is secreted almost instantaneously in response to very slight reductions in serum ionized calcium, which are sensed by . . . [Full Text of this Article]



   Familial hypocalciuric hypercalcaemia (FHH)
 


   Calcimimetics
 


   Familial hyperparathyroidism
 
RET-gene
MEN-1 gene
HRPT-2 gene

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