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Updated: Dec 12, 2025
07:35
Use of Ultra-high Field MRI in Small Rodent Models of Polycystic Kidney Disease for In Vivo Phenotyping and Drug Monitoring
Published on: June 23, 2015
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The CKD-MBD Syndrome: Hysteresis in PTH Involvement and PTH Administration for Its Management
Michael Pazianas1, Paul D Miller2,3
1Institute of Musculoskeletal Sciences, Oxford University, Oxford, UK.
Summary
Chronic kidney disease (CKD) disrupts mineral balance. Early intermittent parathyroid hormone (PTH) administration may prevent secondary hyperparathyroidism by addressing calcium and phosphate retention, improving CKD-MBD management.
Area of Science:
- Nephrology
- Endocrinology
- Mineral Metabolism
Background:
- Chronic kidney disease (CKD) disrupts mineral homeostasis, leading to CKD-mineral and bone disorders (CKD-MBD).
- Current CKD-MBD treatments have limitations.
- Phosphate retention, driven by fibroblast growth factor-23 (FGF-23) and parathyroid hormone (PTH), is an early event, but serum phosphate remains normal until late CKD stages.
Purpose of the Study:
- To investigate the role of calcium retention in PTH response hysteresis during CKD.
- To propose intermittent PTH administration as a strategy to manage CKD-MBD.
Main Methods:
- This study presents a rationale based on existing physiological understanding.
- It does not involve new experimental data but analyzes the proposed mechanism.
Main Results:
- Calcium retention, concurrent with phosphate retention, may cause PTH response hysteresis.
- This hysteresis could contribute to the development of secondary hyperparathyroidism in CKD.
Conclusions:
- Intermittent PTH administration in early CKD could potentially prevent PTH hysteresis.
- This approach may offer a novel strategy for managing CKD-MBD and secondary hyperparathyroidism.
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