FIGURE 3:

PTH resistance. The target organs’ responses to the action of PTH are progressively impaired in CKD, a condition commonly referred to as PTH resistance. Multiple factors are involved, including phosphate loading, calcitriol deficiency, oxidative stress, PTH1R downregulation and dysfunction, accumulation of PTH fragments, antagonists of the Wnt/β-catenin pathway and uremic toxins and accumulation of PTH fragments and uremic toxins.