Atypical cases of secondary hyperparathyroidism in patients with kidney disease and failure: case reports
Abstract
The text is focused on clinical and laboratory manifestations of secondary hyperparathyroidism, associated with chronic kidney disease and chronic renal failure. Presenting four our case reports, we demonstrate not only the complex and complicated "traditional" SHPT pathogenesis associated with kidney disease, but also others involving and contributing factors and problems.
First, in some patients, it may be difficult to properly recognize between primary and secondary hyperparathyroidism. Additionally, the role of vitamin D deficiency as the crucial factor in parathyroid gland stimulation is demonstrated.
Also, the role of dialysis solution composition on parathyroid gland activity is described. All case reports are presented together with commentaries, which contain the pathophysiological explanation as well as the suggested therapeutic approach.