Abstract
Much has been learnt over the past 80 years of the pathogenesis and management of hyperparathyroid bone disease in uraemia. Clinically it has changed from a rare disorder of childhood and adolescence to a common and difficult problem in patients maintained on dialysis programmes. Whereas effective treatments are now available for hyperparathyroid bone disease, these are not curative and there is clearly much more work to be done before a full understanding of its pathogenesis, and the best methods of treatment and prevention, can be reached.
Full text
PDF









Images in this article
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Bouillon R., Verberckmoes R., Moor P. D. Influence of dialysate calcium concentration and vitamin D on serum parathyroid hormone during repetitive dialysis. Kidney Int. 1975 Jun;7(6):422–432. doi: 10.1038/ki.1975.60. [DOI] [PubMed] [Google Scholar]
- Brennan M. F., Brown E. M., Marx S. J., Spiegel A. M., Broadus A. E., Doppman J. L., Webber B., Aurbach G. D. Recurrent hyperparathyroidism from an autotransplanted parathyroid adenoma. N Engl J Med. 1978 Nov 9;299(19):1057–1059. doi: 10.1056/NEJM197811092991909. [DOI] [PubMed] [Google Scholar]
- Brickman A. S., Coburn J. W., Norman A. W. Action of 1,25-dihydroxycholecalciferol, a potent, kidney-produced metabolite of vitamin D, in uremic man. N Engl J Med. 1972 Nov 2;287(18):891–895. doi: 10.1056/NEJM197211022871801. [DOI] [PubMed] [Google Scholar]
- Brownjohn A. M., Goodwin F. J., Hately W., Marsh F. P., O'Riordan J. L., Papapoulos S. E. 1-alpha-hydroxycholecalciferol for renal osteodystrophy. Br Med J. 1977 Sep 17;2(6089):721–723. doi: 10.1136/bmj.2.6089.721. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Buck B. A., Robertson R. D. Indications for parathyroidectomy in advanced renal disease. Surg Gynecol Obstet. 1971 Aug;133(2):218–224. [PubMed] [Google Scholar]
- Chesney R. W., Moorthy A. V., Eisman J. A., Jax D. K., Mazess R. B., DeLuca H. F. Increased growth after long-term oral 1alpha,25-vitamin D3 in childhood renal osteodystrophy. N Engl J Med. 1978 Feb 2;298(5):238–242. doi: 10.1056/NEJM197802022980503. [DOI] [PubMed] [Google Scholar]
- Cundy T. F., Kanis J. A. Renal bone disease. Br J Hosp Med. 1985 Jan;33(1):35–40. [PubMed] [Google Scholar]
- Cundy T., Bartlett M., Bishop M., Earnshaw M., Smith R., Kanis J. A. Plasma hydroxyproline in uremia: relationships with histologic and biological indices of bone turnover. Metab Bone Dis Relat Res. 1983;4(5):297–303. doi: 10.1016/s0221-8747(83)80003-4. [DOI] [PubMed] [Google Scholar]
- Cundy T., Hand D. J., Oliver D. O., Woods C. G., Wright F. W., Kanis J. A. Who gets renal bone disease before beginning dialysis? Br Med J (Clin Res Ed) 1985 Jan 26;290(6464):271–275. doi: 10.1136/bmj.290.6464.271. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Ellis H. A., Peart K. M. Azotaemic renal osteodystrophy: a quantitative study on iliac bone. J Clin Pathol. 1973 Feb;26(2):83–101. doi: 10.1136/jcp.26.2.83. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Felsenfeld A. J., Harrelson J. M., Gutman R. A., Wells S. A., Jr, Drezner M. K. Osteomalacia after parathyroidectomy in patients with uremia. Ann Intern Med. 1982 Jan;96(1):34–39. doi: 10.7326/0003-4819-96-1-34. [DOI] [PubMed] [Google Scholar]
- Fraser D. R., Kodicek E. Unique biosynthesis by kidney of a biological active vitamin D metabolite. Nature. 1970 Nov 21;228(5273):764–766. doi: 10.1038/228764a0. [DOI] [PubMed] [Google Scholar]
- Frei U., Klempa I., Schneider M., Scheuermann E. H., Koch K. M. Tumour-like growth of parathyroid autografts in uraemic patients. Proc Eur Dial Transplant Assoc. 1981;18:548–555. [PubMed] [Google Scholar]
- Henderson R. G., Russell R. G., Ledingham J. G., Smith R., Oliver D. O., Walton R. J., Small D. G., Preston C., Warner G. T. Effects of 1,25-dihydroxycholecalciferol on calcium absorption, muscle weakness, and bone disease in chronic renal failure. Lancet. 1974 Mar 9;1(7854):379–384. doi: 10.1016/s0140-6736(74)93149-3. [DOI] [PubMed] [Google Scholar]
- Kanis J. A., Cundy T., Earnshaw M., Henderson R. G., Heynen G., Naik R., Russell R. G., Smith R., Woods C. G. Treatment of renal bone disease with 1 alpha-hydroxylated derivatives of vitamin D3. Clinical, biochemical, radiographic and histological responses. Q J Med. 1979 Apr;48(190):289–322. [PubMed] [Google Scholar]
- Kanis J. A., Russell R. G. Rate of reversal of hypercalcaemia and hypercalciuria induced by vitamin D and its 1alpha-hydroxylated derivatives. Br Med J. 1977 Jan 8;1(6053):78–81. doi: 10.1136/bmj.1.6053.78. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Neff M. S., Eiser A. R., Slifkin R. F., Baum M., Baez A., Gupta S., Amarga E. Patients surviving 10 years of hemodialysis. Am J Med. 1983 Jun;74(6):996–1004. doi: 10.1016/0002-9343(83)90799-4. [DOI] [PubMed] [Google Scholar]
- Nielsen H. E., Melsen F., Christensen M. S., Hansen H. E., Rodbro P., Johannsen A. 1alpha-hydroxychloecalciferol treatment of long-term hemodialyzed patients. Effects on mineral metabolism, bone mineral content and bone morphometry. Clin Nephrol. 1977 Oct;8(4):429–434. [PubMed] [Google Scholar]
- Nielsen H. E., Rømer F. K., Melsen F., Christensen M. S., Hansen H. E. 1 alpha-hydroxy vitamin D3 treatment of non-dialyzed patients with chronic renal failure. Effects on bone, mineral metabolism and kidney function. Clin Nephrol. 1980 Mar;13(3):103–108. [PubMed] [Google Scholar]
- Pappenheimer A. M., Wilens S. L. Enlargement of the Parathyroid Glands in Renal Disease. Am J Pathol. 1935 Jan;11(1):73–91. [PMC free article] [PubMed] [Google Scholar]
- Parfitt A. M. The actions of parathyroid hormone on bone: relation to bone remodeling and turnover, calcium homeostasis, and metabolic bone disease. Part I of IV parts: mechanisms of calcium transfer between blood and bone and their cellular basis: morphological and kinetic approaches to bone turnover. Metabolism. 1976 Jul;25(7):809–844. doi: 10.1016/0026-0495(76)90151-7. [DOI] [PubMed] [Google Scholar]
- Parsons L. G. The Bone Changes Occurring in Renal and Coeliac Infantilism, and Their Relationship to Rickets: Part I. Renal Rickets. Arch Dis Child. 1927;2(7):1–25. doi: 10.1136/adc.2.7.1. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Recker R., Schoenfeld P., Letteri J., Slatopolsky E., Goldsmith R., Brickman A. The efficacy of calcifediol in renal osteodystrophy. Arch Intern Med. 1978 May 15;138(Spec No):857–863. [PubMed] [Google Scholar]
- Sharman V. L., Brownjohn A. M., Goodwin F. J., Hately W., Manning R. M., O'Riordan J. H., Papapoulos S. E., Marsh F. P. Long-term experience of alfacalcidol in renal osteodystrophy. Q J Med. 1982 Summer;51(203):271–278. [PubMed] [Google Scholar]
- Slatopolsky E., Caglar S., Pennell J. P., Taggart D. D., Canterbury J. M., Reiss E., Bricker N. S. On the pathogenesis of hyperparathyroidism in chronic experimental renal insufficiency in the dog. J Clin Invest. 1971 Mar;50(3):492–499. doi: 10.1172/JCI106517. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Verberckmoes R., Bouillon R., Krempien B. Osteodystrophy of dialysed patients treated with vitamin D. Proc Eur Dial Transplant Assoc. 1973;10(0):217–226. [PubMed] [Google Scholar]







