Pathogenesis of parathyroid hyperplasia in renal failure

Mario Cozzolino, Diego Brancaccio, Maurizio Gallieni, Andrea Galassi, Eduardo Slatopolsky, Adriana Dusso

Research output: Contribution to journalReview articlepeer-review

59 Scopus citations


In chronic kidney disease, secondary hyperparathyroidism (HPTH) is characterized by parathyroid hyperplasia and enhanced synthesis and secretion of parathyroid hormone (PTH). Elevated PTH levels cause renal osteodistrophy and cardiovascular complications, with significantly increased morbidity and mortality in renal failure. The three main direct causes of renal HPTH are hypocalcemia, hyperphosphatemia and vitamin D deficiency. A link between the mechanisms controlling proliferation and hormonal production also exists in normal parathyroid cells which respond to the stimulus of chronic hypocalcemia, not only by an increase in PTH release but also with a consequent parathyroid cell proliferation. The mechanisms responsible for this link, however, remain poorly understood. In this review, we analyze the current understanding concerning the new insights into the molecular mechanisms of parathyroid hyperplasia and PTH secretion in renal failure regulated by calcium, phosphate and vitamin D.

Original languageEnglish
Pages (from-to)5-8
Number of pages4
JournalJournal of Nephrology
Issue number1
StatePublished - Jan 2005


  • Calcium
  • Chronic renal failure
  • Phosphate
  • PTH
  • Vitamin D


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