Which Outcome in Chronic Kidney Disease-Mineral and Bone Disorder Patients?

Secondary hyperparathyroidism (SHPT) is one the major complications in dialysis patients. Hyperphosphatemia, hypocalcemia, low serum vitamin D levels are greatly involved into the physiopathology of SHPT in chronic kidney disease (CKD), in which the down-regulation of parathyroid Vitamin D Receptor (VDR) and Calcium Sensing Receptor (CaSR) represent a critical step. Moreover, new data demonstrate that the Fibroblast Growth Factor 23 (FGF-23) plays an important role in the regulation of calcium-phosphate-vitamin D axis in CKD. Thus, new insights into the pathogenesis of SHPT give the possibility to have different treatments of this condition in CKD