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Parathyroid Hormone: A Uremic Toxin

1
LIM 16, Nephrology Department, Hospital das Clínicas HCFMUSP, Universidade de São Paulo, São Paulo 05403-000, Brazil
2
Post-Graduation, Universidade Nove de Julho (UNINOVE), São Paulo 01525-000, Brazil
*
Author to whom correspondence should be addressed.
Toxins 2020, 12(3), 189; https://doi.org/10.3390/toxins12030189
Received: 31 January 2020 / Revised: 8 March 2020 / Accepted: 8 March 2020 / Published: 17 March 2020
(This article belongs to the Special Issue Comorbidities in Chronic Kidney Disease (CKD))
Parathyroid hormone (PTH) has an important role in the maintenance of serum calcium levels. It activates renal 1α-hydroxylase and increases the synthesis of the active form of vitamin D (1,25[OH]2D3). PTH promotes calcium release from the bone and enhances tubular calcium resorption through direct action on these sites. Hallmarks of secondary hyperparathyroidism associated with chronic kidney disease (CKD) include increase in serum fibroblast growth factor 23 (FGF-23), reduction in renal 1,25[OH]2D3 production with a decline in its serum levels, decrease in intestinal calcium absorption, and, at later stages, hyperphosphatemia and high levels of PTH. In this paper, we aim to critically discuss severe CKD-related hyperparathyroidism, in which PTH, through calcium-dependent and -independent mechanisms, leads to harmful effects and manifestations of the uremic syndrome, such as bone loss, skin and soft tissue calcification, cardiomyopathy, immunodeficiency, impairment of erythropoiesis, increase of energy expenditure, and muscle weakness. View Full-Text
Keywords: parathyroid hormone; secondary hyperparathyroidism; uremic toxin parathyroid hormone; secondary hyperparathyroidism; uremic toxin
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MDPI and ACS Style

Duque, E.J.; Elias, R.M.; Moysés, R.M.A. Parathyroid Hormone: A Uremic Toxin. Toxins 2020, 12, 189.

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