Impaired Parathyroid Hormone Metabolism in Patients with Chronic Renal Failure

Abstract

SECONDARY hyperparathyroidism, with markedly elevated levels of circulating parathyroid hormone, is a universal complication of chronic renal failure.^{1 , 2} Increased secretion has been accepted as the underlying mechanism responsible for the high levels of parathyroid hormone seen in uremic subjects. Multiple factors have been implicated in the pathogenesis of parathyroid hormone hypersecretion in chronic renal disease, including phosphate retention,³ impaired production of 1,25-dihydroxycholecalciferol⁴ leading to impaired intestinal calcium absorption,^{5 , 6} and skeletal resistance to the action of parathyroid hormone.^{7 , 8} In recent years, the importance of the kidney in the metabolism of parathyroid hormone has been recognized. Berson and Yalow⁹ demonstrated a prolonged . . .