Is there an optimal parathyroid hormone level in end-stage renal failure: The lower the better?

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Skeletal resistance to parathyroid hormone is well defined in patients with chronic renal failure. In recent years, with the increased frequency of development of adynamic bone disease, it has been recognized that secondary hyperparathyroidism must exist as a 'trade off' mechanism to maintain skeletal bone remodeling in this patient population. An optimal level of intact parathyroid hormone to maintain the normal skeletal bone turnover is believed to be between 2.0 and 2.5 times the upper limit of normal parathyroid hormone. It has very recently been argued that the optimal parathyroid hormone level for maintenance of skeletal bone remodeling may be insufficient to prevent the extraskeletal complications of coronary artery calcifications, calcific valvular heart disease, and cardiac death. To provide optimal health care for these patients several new treatments have been developed, including use of new vitamin D analogs, calcimimetic agents, and noncalcium-based phosphorus binders. It is anticipated that with lower suppression of parathyroid hormone by these vitamin D analogs, intermittent suppression of parathyroid hormone with calcimimetic agents, and the use of noncalcium phosphorus binders (Renagel™) by regulating serum calcium, the resultant phosphorus concentrations will provide an optimal parathyroid hormone activity to maintain skeletal bone remodeling, while preventing extraskeletal complications.

Original languageEnglish (US)
Pages (from-to)421-427
Number of pages7
JournalCurrent Opinion in Nephrology and Hypertension
Volume10
Issue number3
DOIs
StatePublished - 2001

Fingerprint

Parathyroid Hormone
Chronic Kidney Failure
Bone Remodeling
Calcimimetic Agents
Phosphorus
Vitamin D
Heart Valve Diseases
Secondary Hyperparathyroidism
Bone Diseases
Coronary Vessels
Maintenance
Calcium
Delivery of Health Care
Serum
Population

ASJC Scopus subject areas

  • Nephrology
  • Internal Medicine

Cite this

@article{f609fcf9fc7b49dba82ee80f0426d38c,
title = "Is there an optimal parathyroid hormone level in end-stage renal failure: The lower the better?",
abstract = "Skeletal resistance to parathyroid hormone is well defined in patients with chronic renal failure. In recent years, with the increased frequency of development of adynamic bone disease, it has been recognized that secondary hyperparathyroidism must exist as a 'trade off' mechanism to maintain skeletal bone remodeling in this patient population. An optimal level of intact parathyroid hormone to maintain the normal skeletal bone turnover is believed to be between 2.0 and 2.5 times the upper limit of normal parathyroid hormone. It has very recently been argued that the optimal parathyroid hormone level for maintenance of skeletal bone remodeling may be insufficient to prevent the extraskeletal complications of coronary artery calcifications, calcific valvular heart disease, and cardiac death. To provide optimal health care for these patients several new treatments have been developed, including use of new vitamin D analogs, calcimimetic agents, and noncalcium-based phosphorus binders. It is anticipated that with lower suppression of parathyroid hormone by these vitamin D analogs, intermittent suppression of parathyroid hormone with calcimimetic agents, and the use of noncalcium phosphorus binders (Renagel™) by regulating serum calcium, the resultant phosphorus concentrations will provide an optimal parathyroid hormone activity to maintain skeletal bone remodeling, while preventing extraskeletal complications.",
author = "Khashayar Sakhaee",
year = "2001",
doi = "10.1097/00041552-200105000-00020",
language = "English (US)",
volume = "10",
pages = "421--427",
journal = "Current Opinion in Nephrology and Hypertension",
issn = "1062-4821",
publisher = "Lippincott Williams and Wilkins",
number = "3",

}

TY - JOUR

T1 - Is there an optimal parathyroid hormone level in end-stage renal failure

T2 - The lower the better?

AU - Sakhaee, Khashayar

PY - 2001

Y1 - 2001

N2 - Skeletal resistance to parathyroid hormone is well defined in patients with chronic renal failure. In recent years, with the increased frequency of development of adynamic bone disease, it has been recognized that secondary hyperparathyroidism must exist as a 'trade off' mechanism to maintain skeletal bone remodeling in this patient population. An optimal level of intact parathyroid hormone to maintain the normal skeletal bone turnover is believed to be between 2.0 and 2.5 times the upper limit of normal parathyroid hormone. It has very recently been argued that the optimal parathyroid hormone level for maintenance of skeletal bone remodeling may be insufficient to prevent the extraskeletal complications of coronary artery calcifications, calcific valvular heart disease, and cardiac death. To provide optimal health care for these patients several new treatments have been developed, including use of new vitamin D analogs, calcimimetic agents, and noncalcium-based phosphorus binders. It is anticipated that with lower suppression of parathyroid hormone by these vitamin D analogs, intermittent suppression of parathyroid hormone with calcimimetic agents, and the use of noncalcium phosphorus binders (Renagel™) by regulating serum calcium, the resultant phosphorus concentrations will provide an optimal parathyroid hormone activity to maintain skeletal bone remodeling, while preventing extraskeletal complications.

AB - Skeletal resistance to parathyroid hormone is well defined in patients with chronic renal failure. In recent years, with the increased frequency of development of adynamic bone disease, it has been recognized that secondary hyperparathyroidism must exist as a 'trade off' mechanism to maintain skeletal bone remodeling in this patient population. An optimal level of intact parathyroid hormone to maintain the normal skeletal bone turnover is believed to be between 2.0 and 2.5 times the upper limit of normal parathyroid hormone. It has very recently been argued that the optimal parathyroid hormone level for maintenance of skeletal bone remodeling may be insufficient to prevent the extraskeletal complications of coronary artery calcifications, calcific valvular heart disease, and cardiac death. To provide optimal health care for these patients several new treatments have been developed, including use of new vitamin D analogs, calcimimetic agents, and noncalcium-based phosphorus binders. It is anticipated that with lower suppression of parathyroid hormone by these vitamin D analogs, intermittent suppression of parathyroid hormone with calcimimetic agents, and the use of noncalcium phosphorus binders (Renagel™) by regulating serum calcium, the resultant phosphorus concentrations will provide an optimal parathyroid hormone activity to maintain skeletal bone remodeling, while preventing extraskeletal complications.

UR - http://www.scopus.com/inward/record.url?scp=0035022845&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0035022845&partnerID=8YFLogxK

U2 - 10.1097/00041552-200105000-00020

DO - 10.1097/00041552-200105000-00020

M3 - Article

C2 - 11342808

AN - SCOPUS:0035022845

VL - 10

SP - 421

EP - 427

JO - Current Opinion in Nephrology and Hypertension

JF - Current Opinion in Nephrology and Hypertension

SN - 1062-4821

IS - 3

ER -