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The parathyroid-calcitriol axis in health and chronic renal failure

Slatopolsky, E.; Lopez-Hilker, S.; Delmez, J.; Dusso, A.; Brown, A.; Martin, K.J.

Kidney International. Supplement 29: S41-S47

1990

ISSN/ISBN: 0098-6577
PMID: 2170737
Document Number: 354355
Calcitriol and calcium play a key role in the synthesis and secretion of parathyrin (PTH). The effects of Ca on PTH secretion take place within minutes whereas, calcitriol suppresses PTH secretion only after 12 to 24 h. In patients with chronic renal failure, high concentrations of serum calcitriol increase the sensitivity of the parathyroid gland to Ca and provides an effective therapeutic tool in the control of secondary hyperparathyroidism. In early renal failure, phosphorus restriction improves secondary hyperparathyroidism by increasing the concentrations of calcitriol. In advanced renal failure, P restriction improves secondary hyperparathyroidism by a mechanism that is not related to calcitriol or ionized Ca. The effect of P restriction is not yet fully understood.

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