Abstract:Renal hyperparathyroidism (rHPT) is an adaptive response of human body based on the disorder of calcium and phosphorus metabolism in chronic kidney disease (CKD) and the progressive aggravation of vitamin D hypofunction, characterized by hyperparathyroidism and excessive synthesis and secretion of parathyroid hormone (PTH). It occurs in the early stage of renal failure and is associated with increased risk of fracture, cardiovascular disease and death. The vitamin D supplementation and reduction of phosphorus intake can be used in the early stage of CKD, while calcium mimetic agent can be used in the end-stage of CKD. For the refractory secondary hyperparathyroidism (SHPT) with poor drug treatment, parathyroidectomy can be performed. Renal transplantation can improve rHPT, but can’t cure that. In this review, we summarized the pathophysiology, diagnosis and drug treatment of rHPT, elaborated the effect of renal transplantation, and discussed the indication and strategy on SHPT.
