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NDT Advance Access originally published online on December 22, 2008
Nephrology Dialysis Transplantation 2009 24(3):707-709; doi:10.1093/ndt/gfn717
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© The Author [2008]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org


Regression of parathyroid hyperplasia by calcimimetics—fact or illusion?

Hirotaka Komaba and Masafumi Fukagawa

Division of Nephrology and Kidney Center, Kobe University School of Medicine, Kobe, Japan

Correspondence and offprint requests to: Masafumi Fukagawa, Division of Nephrology and Kidney Center, Kobe University School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan. Tel: +81-78-382-6500; Fax: +81-78-382-6509; E-mail: fukagawa@med.kobe-u.ac.jp

Keywords: calcimimetics; cinacalcet; parathyroid hyperplasia; secondary hyperparathyroidism

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

Secondary hyperparathyroidism is one of the most common and serious complications of chronic kidney disease (CKD). The main factors responsible for excessive synthesis and secretion of parathyroid hormone (PTH) include phosphate retention, hypocalcaemia and calcitriol deficiency resulting from decreased kidney function [1,2]. Sustained hypersecretion of PTH is associated with an increase in the parathyroid gland size, initially leading to diffuse parathyroid hyperplasia. Subsequently, some cells in the parathyroid glands proliferate in a monoclonal growth pattern, and the enlarged glands exhibit an advanced type of nodular hyperplasia [3]. In the course of parathyroid hyperplasia, both calcium-sensing receptors (CaSR) and vitamin D receptors (VDR) are progressively down-regulated [4,5], which results in diminished responsiveness of parathyroid glands with nodular hyperplasia to active vitamin D treatment.

Conversely, whether regression of parathyroid hyperplasia can occur has remained a matter of discussion. Regression of parathyroid hyperplasia has been reported in . . . [Full Text of this Article]


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