Protein Information

Name parathyroid hormone
Synonyms PTH; Parathormone; Parathyrin; Parathyroid hormone; Parathyroid hormone precursor; Parathormones; Parathyrins; Parathyroid hormones…

Compound Information

Name phosphorus
CAS phosphorus

Reference List

PubMed Abstract RScore(About this table)
19746344 Stillion JR, Ritt M: Renal secondary hyperparathyroidism. . Compend Contin Educ Vet. 2009;31(6):E1-E11.

Renal secondary hyperparathyroidism is a complex, multifactorial syndrome that involves changes in circulating levels of calcium, parathyroid hormone (PTH), phosphorus, and 1,25-dihydroxycholecalciferol (calcitriol).
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20089501 Raggi P, Vukicevic S, Moyses RM, Wesseling K, Spiegel DM: Ten-year experience with sevelamer and calcium salts as phosphate binders. Clin J Am Soc Nephrol. 2010 Jan;5 Suppl 1:S31-40.

Most patients with chronic kidney disease experience abnormalities in serum calcium, phosphorus, parathyroid hormone, and vitamin D metabolism.
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19507637 Akin M, Atasever T, Kurukahvecioglu O, Dogan M, Gokaslan D, Poyraz A, Koksal H, Taneri F: Preoperative detection of parathyroid adenomas with Tc-99m MIBI and Tc-99m pertechnetate scintigraphy: histopathological and biochemical correlation with Tc-99m MIBI uptake. Bratisl Lek Listy. 2009;110(3):166-9.

MIBI uptake was also compared with serum calcium (Ca), phosphorus (P) and intact parathormone (iPTH) levels.
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19598003 Imachi H, Murao K, Kontani K, Yokomise H, Miyai Y, Yamamoto Y, Kushida Y, Haba R, Ishida T: Ectopic mediastinal parathyroid adenoma: a cause of acute pancreatitis. . Endocrine. 2009 Oct;36(2):194-7. Epub 2009 Jul 14.

After the episode of acute pancreatitis subsided, laboratory investigation revealed increased serum calcium (12.0 mg/dl), decreased serum phosphorus (2.7 mg/dl), and increased serum parathyroid hormone (intact) levels (131 pg/ml).
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19758297 Ibrahim S: Quality of care assessment and adherence to the international guidelines considering dialysis, water treatment, and protection against transmission of infections in university hospital-based dialysis units in Cairo, Egypt. Hemodial Int. 2009 Sep 16.

The mean serum calcium was 8.66 +/- 1.4 mg/dL, phosphorus was 6.26 +/- 2.54 mg/dL, and approximately 60% of patients had a serum phosphorus level > 5.5 mg/dL.
The CaxPi product was higher than 55 in around 40% of the cases, and the parathyroid hormone level was in the range of 150 to 300 pg/mL in around 10% of prevalent patients.
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19615558 McKay CP, Portale A: Emerging topics in pediatric bone and mineral disorders 2008. Semin Nephrol. 2009 Jul;29(4):370-8.

The calcium sensing receptor (CaSR) and fibroblast growth factor 23 (FGF-23) play central roles in the regulation of calcium and phosphorus metabolism, respectively.
CaSR controls parathyroid hormone secretion and renal calcium reabsorption.
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20150282 Sun W, Sun W, Liu J, Zhou X, Xiao Y, Karaplis A, Pollak MR, Brown E, Goltzman D, Miao D: Alterations in phosphorus, calcium and PTHrP contribute to defects in dental and dental alveolar bone formation in calcium-sensing receptor-deficient mice. Development. 2010 Mar;137(6):985-92. Epub 2010 Feb 11.

We also attempted to rescue the phenotype of CaR (-/-) mice by genetic means, in mice doubly homozygous for CaR and 25-hydroxyvitamin D 1alpha-hydroxylase [1alpha (OH) ase] or parathyroid hormone (Pth).
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19943551 Tarcoveanu E, Niculescu D, Moldovanu R, Cotea E, Vasilescu A, Danila N, Lazescu D, Ferariu D, Crumpei F, Ichim M, Zbranca E: [Surgical treatment of hyperparathyroidism] . Chirurgia. 2009 Sep-Oct;104(5):531-44.


BACKGROUND: Hyperparathyroidism (HPT), the result of excessive secretion of the parathormone, is one of the most common endocrine disorders.
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20189664 Slinin Y, Blackwell T, Ishani A, Cummings SR, Ensrud KE: Serum calcium, phosphorus and cardiovascular events in post-menopausal women. Int J Cardiol. 2010 Feb 26.

Adjusted for multiple covariates including 25 (OH) D, parathyroid hormone, and phosphorus, adjusted hazard ratios (AHR) (95% confidence interval (CI)) per SD of calcium were: 1.17 (1.01-1.35), p=0.03 for combined cardiovascular outcome, 1.22 (0.99-1.49), p=0.06 for cerebrovascular events, 1.12 (0.92-1.37), p=0.25 for coronary heart disease, and 1.18 (0.94-1.48), p=0.16 for death.
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20237058 Pelletier S, Roth H, Bouchet JL, Drueke T, London G, Fouque D: Mineral and bone disease pattern in elderly haemodialysis patients. Nephrol Dial Transplant. 2010 Mar 21.

METHODS: We prospectively collected serum phosphorus, calcium, parathyroid hormone (PTH), 25 (OH) vitamin D, albumin, C-reactive protein, protein intake and CKD-MBD treatments in 9169 maintenance haemodialysis patients in France in June 2008.
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19587481 Zhu X, Zhai H, Tang SF, Cheng Y: Intrathyroidal parathyroid adenoma presenting with neuromuscular manifestation. Neurol India. 2009 May-Jun;57(3):340-3.

Serum calcium, alkaline phosphatase, and parathyroid hormone were elevated and serum phosphorus was low.
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19715856 Gomez Marques G, Obrador Mulet A, Vilar Gimeno A, Pascual Felip MJ, Alarcon Zurita A, Molina Guasch M, Uriol Rivera M, Munar Vila MA, Losada Gonzalez P: Treatment with cinacalcet of secondary hyperparathyroidism after renal transplantation. Transplant Proc. 2009 Jul-Aug;41(6):2139-43.


Calcimimetics inhibit parathyroid hormone (PTH) secretion by modulating the calcium-sensing receptor in the parathyroid gland.
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19301038 Wesseling-Perry K, Harkins GC, Wang HJ, Sahney S, Gales B, Elashoff RM, Juppner H, Salusky IB: Response of different PTH assays to therapy with sevelamer or CaCO3 and active vitamin D sterols. Pediatr Nephrol. 2009 Jul;24(7):1355-61. Epub 2009 Mar 20.

Amino-terminally truncated parathyroid hormone (PTH) fragments are detected to differing degrees by first- and second-generation immunometric PTH assays (PTH-IMAs), and acute changes in serum calcium affect the proportion of these fragments in circulation.
Serum phosphorus levels did not differ between groups.
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19548061 Karga H, Papaioannou G, Polymeris A, Papamichael K, Karpouza A, Samouilidou E, Papaioannou P: The effects of recombinant human TSH on bone turnover in patients after thyroidectomy. J Bone Miner Metab. 2010;28(1):35-41. Epub 2009 Jun 23.


Serum parathyroid hormone (PTH) started to rise along with TSH, but a significant increase of PTH was only reached on Day 5 when the TSH concentration had fallen more than 80% of the peak value.
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20059333 Bergwitz C, Juppner H: Regulation of phosphate homeostasis by PTH, vitamin D, and FGF23. . Annu Rev Med. 2010;61:91-104.

Fibroblast growth factor 23 (FGF23) is part of a previously unrecognized hormonal bone-parathyroid-kidney axis, which is modulated by PTH, 1,25 (OH)(2)-vitamin D (1,25 (OH)(2) D), dietary and serum phosphorus levels.
In turn, FGF23 inhibits the synthesis of 1,25 (OH)(2) D, and it may negatively regulate the secretion of parathyroid hormone (PTH) from the parathyroid glands.
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19718820 Berezhnova IA, Korshunov GV: [Biochemical markers of bone resorption and formation in geriatric patients with ischemic heart disease and osteoporosis]. Klin Lab Diagn. 2009 Jul;(7):3-7.

The serum levels of total cholesterol, triglycerides, high-density lipoproteins, low-density lipoproteins, apoA- and apoB-lipoproteins, calcium, phosphorus, alkaline phosphatase, etc. were measured on a Vitalab Flexor E. biochemical analyzer.
Bone metabolic markers, such as parathyroid hormone (PTH), osteocalcin (OC), calcitonin (CT), as well as C-terminal telopeptides (CTTP) resulting from collagen type I (in serum and urine) were determined on a Stat Fax photometer.
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20116689 Smith LB, Fadrowski JJ, Howe CJ, Fivush BA, Neu AM, Furth SL: Secondary hyperparathyroidism and anemia in children treated by hemodialysis. Am J Kidney Dis. 2010 Feb;55(2):326-34.

PREDICTOR: Intact parathyroid hormone (iPTH) levels assessed in October, November, and December 2001 and categorized as quintiles.
OUTCOMES & MEASUREMENTS: Achievement of serum hemoglobin level > or = 11 g/dL was assessed using Poisson regression adjusting for sex, age, race, dialysis vintage, vascular access type, single-pool Kt/V, serum albumin level, normalized protein catabolic rate, calcium-phosphorus product, and erythropoietin alfa dose.
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19628941 Moro-Alvarez MJ, Diaz Curiel M, de la Piedra C, Marinoso ML, Carrascal MT: Bone disease induced by phenytoin therapy: clinical and experimental study. Eur Neurol. 2009;62(4):219-30. Epub 2009 Jul 23.


In these male Wistar rats, the administration of DPH produced a tendency towards increasing the markers of resorption and, though changes in serum levels of calcium and phosphorus were not observed, to provoke an increase in the parathyroid hormone levels; with normal levels of 1,25 (OH)(2) D which has produced the same inclination in rats as in humans.
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19692157 Navaneethan SD, Palmer SC, Craig JC, Elder GJ, Strippoli GF: Benefits and harms of phosphate binders in CKD: a systematic review of randomized controlled trials. Am J Kidney Dis. 2009 Oct;54(4):619-37. Epub 2009 Aug 18.

OUTCOMES: Serum phosphorus, calcium, and parathyroid hormone levels; incidence of hypercalcemia; all-cause mortality; adverse effects.
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19758299 Levitt H, Smith KG, Rosner MH: Variability in calcium, phosphorus, and parathyroid hormone in patients on hemodialysis. Hemodial Int. 2009 Oct;13(4):518-25. Epub 2009 Sep 16.
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20305510 Cecchetti DF, Paula SA, Cruz AA, Lucca L Jr, Nogueira-Barbosa MH, Chahud F, Conti-Freitas LC, Melo CB: Orbital involvement in craniofacial brown tumors. Ophthal Plast Reconstr Surg. 2010 Mar-Apr;26(2):106-11.

Laboratory results such as serum levels of alkaline phosphatase, calcium, phosphorus, and parathyroid hormone were recorded.
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20336459 Shinjo SK, Bonfa E, de Falco Caparbo V, Pereira RM: Low bone mass in juvenile onset sclerosis systemic: the possible role for 25-hydroxyvitamin D insufficiency. Rheumatol Int. 2010 Mar 25.

Laboratorial analysis included autoantibodies, 25-hydroxyvitamin D (25OHD), intact parathyroid hormone, calcium, phosphorus, alkaline phosphatase and albumin sera levels.
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20349428 Sirvent AE, Gonzalez C, Enriquez R, Fernandez J, Millan I, Barber X, Amoros F: Serum tryptase levels and markers of renal dysfunction in a population with chronic kidney disease. J Nephrol. 2010 Mar 26. pii: C0C2F712-6AAB-4CAC-BA1A-22FA73658087.

In univariate analysis, in the conservative treatment CKD population, tryptase was positively correlated with urea, creatinine, potassium, uric acid, phosphorus, parathyroid hormone, homocysteine, fibrinogen and proteinuria (p <0.01); tryptase was negatively correlated with calcium, albumin, creatinine clearance, estimated glomerular filtration rate (by abbreviated MDRD equation) and urine creatinine (p <0.01).
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20124547 Avila M, Prado C, Ventura MD, Mora C, Briones D, Valdez H, Hurtado ME, Lindholm B, Qureshi A, Castillo-Henkel C, Paniagua R: Vitamin D receptor gene, biochemical bone markers and bone mineral density in Mexican women on dialysis. Nephrol Dial Transplant. 2010 Feb 2.

METHODS: In a cross-sectional study, 197 women (42 +/- 10 years; 25% with diabetes mellitus (DM); body mass index (BMI) 25.26 +/- 4.77 kg/m (2)) treated by PD (72%) or HD (28%) underwent measurements of BMD (measured at the calcaneus by quantitative ultrasound; expressed as T- and Z-scores) and plasma total calcium (tCa), intact parathyroid hormone 1-84 (iPTH), phosphorus, albumin, glucose, osteoprotegerin (OPG), fetuin-A, intact osteocalcin-49 and N-MID fragment 1-43 aa (N-MID osteocalcin) N-terminal propeptide of type 1 procollagen (PINP) and C-terminal telopeptide-beta aspartic acid (BCL).
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19620198 Huh SY, Feldman HA, Cox JE, Gordon CM: Prevalence of transient hyperphosphatasemia among healthy infants and toddlers. Pediatrics. 2009 Aug;124(2):703-9. Epub 2009 Jul 20.

We measured serum levels of alkaline phosphatase (AP), 25-hydroxyvitamin D, parathyroid hormone (PTH), calcium, magnesium, and phosphorus.
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20167032 Ashkar ZM: Association of calcium-phosphorus product with blood pressure in dialysis. J Clin Hypertens. 2010 Feb 1;12(2):96-103.

Multilinear regression analysis was then done between ca x ph product and BPs adjusting for age, sex, hemoglobin, diabetes, albumin, parathyroid hormone, ultrafiltration volume, and average BP medications per patient.
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19713297 Moore C, Yee J, Malluche H, Rao DS, Monier-Faugere MC, Adams E, Daramola-Ogunwuyi O, Fehmi H, Bhat S, Osman-Malik Y: Relationship between bone histology and markers of bone and mineral metabolism in African-American hemodialysis patients. Clin J Am Soc Nephrol. 2009 Sep;4(9):1484-1493.

BACKGROUND AND OBJECTIVES: Racial differences in mineral metabolism exist in the chronic kidney disease population, especially as it relates to intact parathyroid hormone (iPTH) levels.
At the time of biopsy, mean corrected calcium was 9.1, 8.9, and 9.4 mg/dl (P = 0.344); calcium-phosphorus (Ca X PO4) product was 42, 55, and 62 mg (2)/dl (2) (P = 0.002); phosphorus was 4.6, 6.2, and 6.7 mg/dl (P = 0.005); and iPTH was 225, 566, and 975 pg/ml (P = 0.006), respectively.
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20050075 El'chaninov DV, Akker LV, Fedorova IA, Popovtseva AV: [Bone resorption and formation markers in women with climacteric syndrome in early postmenopause]. Klin Lab Diagn. 2009 Oct;(10):21-4.


The level of bone metabolites and the indices of calcium and phosphorus metabolism were measured in 20 women with climacteric syndrome in postmenopause and in 20 women in premenopause, who had normal bone density and did not differ in the modified risk factors of osteoporosis.
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20091666 Geary DF, Hodson EM, Craig JC: Interventions for bone disease in children with chronic kidney disease. . Cochrane Database Syst Rev. 2010 Jan 20;(1):CD008327.


There were no significant differences detected in growth, PTH, serum calcium or phosphorus between daily versus intermittent calcitriol (3 RCTs).
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19715933 Fernandez-Fresnedo G, Rodrigo E, Ruiz JC, Martin de Francisco AL, Arias M: Bone metabolism according to chronic kidney disease stages in patients undergoing kidney transplantation: a 5-year database analysis. Transplant Proc. 2009 Jul-Aug;41(6):2403-5.


The percentage of patients in each stage of chronic kidney disease with calcium levels less than 8.5 mg/dL, phosphorus greater than 4.5 mg/dL, and PTHi greater than 150 pg/mL increased as graft function declined.
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19903041 Gokalp D, Tuzcu A, Bahceci M, Arikan S, Ozmen CA, Cil T: Sheehan's syndrome and its impact on bone mineral density. Gynecol Endocrinol. 2009 May;25(5):344-9.

For both pre- and postmenopausal subjects, compared with respective controls, serum calcium and ALP levels, femur-T score, femur-Z score, spine (L1-L5)-T score, spine (L1-L5)-Z score and BMD values were lower, and phosphorus and parathyroid hormone (PTH) levels were higher in patients with SS.
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20203163 Matias PJ, Jorge C, Ferreira C, Borges M, Aires I, Amaral T, Gil C, Cortez J, Ferreira A: Cholecalciferol Supplementation in Hemodialysis Patients: Effects on Mineral Metabolism, Inflammation, and Cardiac Dimension Parameters. Clin J Am Soc Nephrol. 2010 Mar 4.

Conversely, serum calcium, phosphorus, and intact parathyroid hormone were decreased.
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19423688 Snyder JJ, Collins AJ: Association of preventive health care with atherosclerotic heart disease and mortality in CKD. J Am Soc Nephrol. 2009 Jul;20(7):1614-22. Epub 2009 May 7.

We defined preventive care by the receipt of laboratory measurements (serum creatinine, lipids, calcium and phosphorus, parathyroid hormone, and, for patients with diabetes, hemoglobin A1c), influenza vaccination, and by at least one outpatient visit to a nephrologist.
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20028571 Amaro CR, Goldberg J, Agostinho AD, Damasio P, Kawano PR, Fugita OE, Amaro JL: Metabolic investigation of patients with staghorn calculus: is it necessary?. Int Braz J Urol. 2009 Nov-Dec;35(6):658-61; discussion 662-3.

Two non-consecutive 24-hour urine samples collected to measure calcium, phosphorus, uric acid, sodium, potassium, magnesium, oxalate and citrate, and serum calcium levels, phosphorus, uric acid, sodium, potassium, magnesium, chloride, parathormone and urine pH.
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20144552 Menon B, Harinarayan CV: The effect of anti epileptic drug therapy on serum 25-hydroxyvitamin D and parameters of calcium and bone metabolism--a longitudinal study. Seizure. 2010 Apr;19(3):153-8. Epub 2010 Feb 7.

Base line bone mineral parameters - serum calcium, phosphorus, alkaline phosphatase (SAP), tartrate resistant acid phosphatase (TRACP), 25 (OH) D levels, parathyroid hormone (PTH) and urinary calcium creatinine ratio (Ca.Cr), urinary calcium/kg/bodyweight (BW) and phosphate excretion index (PEI) were determined.
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20065370 Papavasiliou KA, Kenanidis EI, Potoupnis ME, Sarris IK, Kirkos JM, Kapetanos GA: Incidence of secondary hyperparathyroidism among postmenopausal women with end-stage knee osteoarthritis. J Orthop Surg (Hong Kong). 2009 Dec;17(3):310-2.

Their preoperative serum levels of intact parathyroid hormone (I-PTH), calcium, phosphorus, creatinine, and the clearance of creatinine were evaluated.
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19454393 Hamoudeh E, Yaqub A: Evaluation of secondary causes of bone loss in a primary care setting. Endocr Pract. 2009 Jul-Aug;15(5):410-4.

Serum parathyroid hormone was measured in 7% and serum phosphorus in 10% of patients.
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19648299 Vacca A, Cormier C, Piras M, Mathieu A, Kahan A, Allanore Y: Vitamin D deficiency and insufficiency in 2 independent cohorts of patients with systemic sclerosis. J Rheumatol. 2009 Sep;36(9):1924-9. Epub 2009 Jul 31.

METHODS: We studied 156 consecutive SSc patients comparable for demographic characteristics: 90 from Northern France and 66 from Southern Italy. 25-OH vitamin D, intact parathyroid hormone, and serum total calcium and phosphorus were measured in all patients.
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19967658 Ferreira A, Saraiva M, Behets G, Macedo A, Galvao M, D'Haese P, Drueke TB: Evaluation of bone remodeling in hemodialysis patients: serum biochemistry, circulating cytokines and bone histomorphometry. J Nephrol. 2009 Nov-Dec;22(6):783-93.

Serum levels of intact parathyroid hormone (iPTH; 1-84), total alkaline phosphatases (tAP), calcium, phosphate and aluminum (Al) were measured.
Serum calcium and phosphorus, however, did not differ (p=NS).
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20016142 Lund RJ, Andress DL, Amdahl M, Williams LA, Heaney RP: Differential effects of paricalcitol and calcitriol on intestinal calcium absorption in hemodialysis patients. Am J Nephrol. 2010;31(2):165-70. Epub 2009 Dec 11.

METHODS: Patients (n = 22) aged > or =20 years, on maintenance hemodialysis for > or =2 months with intact parathyroid hormone (iPTH) levels of > 200 pg/ml were enrolled in a single-center, double-blind, active-controlled, randomized, crossover trial.
There were no significant differences in serum PTH, Ca, phosphorus (P), or Ca x P.
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20237457 Chiu YW, Adler SG, Budoff MJ, Takasu J, Ashai J, Mehrotra R: Coronary artery calcification and mortality in diabetic patients with proteinuria. Kidney Int. 2010 Mar 17.


However, no association was found between eGFR, serum calcium, phosphorus, parathyroid hormone, or 25-hydroxy vitamin D.
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19270206 Demirci MS, Ozkahya M, Asci G, Sevinc E, Yilmaz M, Demirci C, Toz H, Basci A, Ok E: The influence of dialysate calcium on progression of arterial stiffness in peritoneal dialysis patients. Perit Dial Int. 2009 Feb;29 Suppl 2:S15-7.


We observed no differences between groups with regard to those variables or creatinine clearance, residual renal function, Ca, phosphorus, parathormone, C-reactive protein, lipid parameters, and use of phosphate binder with or without Ca content.
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19504563 Cobanoglu N, Atasoy H, Ozcelik U, Yalcin E, Dogru D, Kiper N, Gocmen A: Relation of bone mineral density with clinical and laboratory parameters in pre-pubertal children with cystic fibrosis. Pediatr Pulmonol. 2009 Jul;44(7):706-12.

After anthropometric measurements, BMD, serum calcium, phosphorus, total alkaline phosphatase (ALP), 25-hydroxy vitamin D (25-OHD), parathyroid hormone, osteocalcin, tumor necrosis factor (TNF)-alpha, soluble TNF-alpha receptor 2 (sTNFR2), and soluble IL-2 receptor (sIL-2R) levels, and urinary calcium and hydroxyproline excretions were assessed.
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19337166 Tantawy AA, El Kholy M, Moustafa T, Elsedfy HH: Bone mineral density and calcium metabolism in adolescents with beta-thalassemia major. Pediatr Endocrinol Rev. 2008 Oct;6 Suppl 1:132-5.

Bone mineral density (BMD) at both the lumbar spine and femoral neck was measured in 40 adolescents with beta thalassemia major (TM) by DXA scanning and correlated to biochemical parameters including calcium, phosphorus, alkaline phosphatase, bone alkaline phosphatase, intact parathyroid hormone and 25-OH vitamin D as well as vitamin D receptor (VDR) gene polymorphisms at exon 2 (Fok1).
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19440993 Petrovic D, Obrenovic R, Stojimirovic B: Risk factors for aortic valve calcification in patients on regular hemodialysis. Int J Artif Organs. 2009 Mar;32(3):173-9.

The variables investigated were: serum albumin, C-reactive protein (CRP), homocysteine, total cholesterol, LDL-cholesterol (LDL-C), HDL-cholesterol (HDL-C), triglycerides (TG), Apolipoprotein A-I (Apo A-I), Apolipoprotein B (Apo B) and lipoprotein (a), calcium, phosphate and parathormone, and calcium-phosphorus product (Ca x P).
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19666939 Khadilkar A, Mughal MZ, Hanumante N, Sayyad M, Sanwalka N, Naik S, Fraser WD, Joshi A, Khadilkar V: Oral calcium supplementation reverses the biochemical pattern of parathyroid hormone resistance in underprivileged Indian toddlers. Arch Dis Child. 2009 Dec;94(12):932-7. Epub 2009 Aug 9.

BACKGROUND: Toddlers in Pune, India, accustomed to low dietary calcium intake but vitamin D replete have low serum ionised calcium and inappropriately raised serum inorganic phosphorus concentrations together with elevated serum parathyroid hormone (PTH) concentrations.
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19516243 Chan KE, Lazarus JM, Wingard RL, Hakim RM: Association between repeat hospitalization and early intervention in dialysis patients following hospital discharge. Kidney Int. 2009 Aug;76(3):331-41. Epub 2009 Jun 10.

Compared to pre-hospitalization values, the levels of hemoglobin, albumin, phosphorus, calcium, and parathyroid hormone and weight were significantly decreased after hospitalization.
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19383807 Tucci JR: Vitamin D therapy in patients with primary hyperparathyroidism and hypovitaminosis D. Eur J Endocrinol. 2009 Jul;161(1):189-93. Epub 2009 Apr 21.

METHODS: Serum calcium, albumin, phosphorus, 25-OHD, intact parathyroid hormone (PTH) and urine calcium/creatinine (Ca/Cr) ratios were measured before and during vitamin D therapy.
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20052352 Kim MJ, Na B, No SJ, Han HS, Jeong EH, Lee W, Han Y, Hyeun T: Nutritional status of vitamin D and the effect of vitamin D supplementation in Korean breast-fed infants. J Korean Med Sci. 2010 Jan;25(1):83-9. Epub 2009 Dec 26.

We measured serum concentrations of vitamin D (25OHD3), calcium (Ca), phosphorus (P), alkaline phosphatase (AP), intact parathyroid hormone (iPTH) and bone mineral density (BMD) at 6 and 12 months of age.
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19934096 Canalejo A, Canalejo R, Rodriguez ME, Martinez-Moreno JM, Felsenfeld AJ, Rodriguez M, Almaden Y: Development of parathyroid gland hyperplasia without uremia: role of dietary calcium and phosphate. Nephrol Dial Transplant. 2010 Apr;25(4):1087-97. Epub 2009 Nov 23.

Many experimental studies have demonstrated that parathyroid cell proliferation is induced by uremia and further aggravated by hypocalcemia, phosphorus retention and vitamin D deficiency.
Thus, the novelty of this work resides in the close examination of the time course for the expected changes in proliferation rates and their association with parathyroid hormone (PTH) release in normal rats under the physiological demands of a high-phosphate diet (HPD) or a low-calcium diet (LCD).
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19952739 Mitchell DM, Juppner H: Regulation of calcium homeostasis and bone metabolism in the fetus and neonate. Curr Opin Endocrinol Diabetes Obes. 2010 Feb;17(1):25-30.

PURPOSE OF REVIEW: Regulation of calcium and phosphorus levels in the fetus and neonate is critical for proper bone development and mineralization.
RECENT FINDINGS: Parathyroid hormone-related peptide plays an important role in transferring calcium across the placenta into the fetal circulation.
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19621176 Kunstmann S, Vukusich A, Michea L, Varela C, Allende I, Bravo S, Gainza D, Sepulveda D, Marusic E, Figueroa F: [Cardiovascular assessment of non diabetic patients on hemodialysis] . Rev Med Chil. 2009 Mar;137(3):351-60. Epub 2009 Jun 15.


No correlations were found between ventricular hypertrophy and dialysis lapse, packed red cell volume, calcium phosphorus product, parathormone levels or median arterial pressure.
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19603188 Sakhaee K: Post-renal transplantation hypophosphatemia. . Pediatr Nephrol. 2010 Feb;25(2):213-20. Epub 2009 Jul 15.


One major difference in the pathophysiology of PRT bone disease is, perhaps, due to persistent renal phosphorus (Pi) wasting.
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19932904 Cheng SP, Yang TL, Lee JJ, Chen HH, Wu CJ, Liu TP, Liu CL: Gender Differences Among Patients with Secondary Hyperparathyroidism Undergoing Parathyroidectomy. J Surg Res. 2009 Aug 22.


No differences in preoperative calcium-phosphorus product, alkaline phosphatase, or parathyroid hormone levels were observed.
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19365139 Wilkie M, Pontoriero G, Macario F, Yaqoob M, Bouman K, Braun J, von Albertini B, Brink H, Maduell F, Graf H, Frazao JM, Bos WJ, Torregrosa V, Saha H, Reichel H, Zani VJ, Carter D, Messa P: Impact of vitamin D dose on biochemical parameters in patients with secondary hyperparathyroidism receiving cinacalcet. Nephron Clin Pract. 2009;112(1):c41-50. Epub 2009 Apr 10.

BACKGROUND/AIMS: The calcimimetic cinacalcet (Mimpara/Sensipar) simultaneously lowers parathyroid hormone (PTH), phosphorus (P) and calcium (Ca) levels in patients with secondary hyperparathyroidism.
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19491914 Jain N, Weinstein RS: Giant osteoclasts after long-term bisphosphonate therapy: diagnostic challenges. Nat Rev Rheumatol. 2009 Jun;5(6):341-6.

INVESTIGATIONS: Bone mineral density determinations, measurement of serum 25-hydroxyvitamin D, intact parathyroid hormone, calcium, inorganic phosphorus, alkaline phosphatase and creatinine levels, urinary excretion levels of the N-telopeptide of type 1 collagen, and bone biopsy.
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19595108 Li N, Wang MY, He L, Jiang X, Wu CA: [Intermittent low-dose administration of recombinant human parathyroid hormone (1-34) promotes the expression of Runx2 during early stage of fracture healing]. Zhonghua Yi Xue Za Zhi. 2009 Mar 24;89(11):771-6.

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19854384 Fisher L, Byrnes E, Fisher AA: Prevalence of vitamin K and vitamin D deficiency in patients with hepatobiliary and pancreatic disorders. Nutr Res. 2009 Sep;29(9):676-83.

The aim of this study was to determine vitamin K of bone, vitamin D and parathyroid hormone status in patients with biliary and pancreatic disorders.
In 90 consecutive patients (mean +/- SD age, 65.5 +/- 17.7 years; 45 females) undergoing endoscopic retrograde cholangiopancreatography (68 with choledocholithiasis, 14 with other benign condition, and 8 with cholangiopancreatic cancers) fasting concentrations of carboxylated (cOC) and undercarboxylated osteocalcin (ucOC), 25-hydroxyvitamin D, calcium, phosphorus, magnesium, prothrombin time, liver function tests, lipase, and creatinine were measured.
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20059427 Lutfioglu M, Sakallioglu U, Sakallioglu EE, Diraman E, Ciftci G, Tutkun F: Dietary-induced hyperparathyroidism affects serum and gingival proinflammatory cytokine levels in rats. J Periodontol. 2010 Jan;81(1):150-7.

METHODS: Twenty-four Sprague-Dawley rats were used in the study. dHPT was induced in 12 rats by calcium/phosphorus imbalance, and 12 rats were fed a standard diet (SD).
RESULTS: Serum cytokines were higher in dHPT rats than in SD rats (P <0.001), with a positive correlation between parathormone and the cytokines (P <0.001).
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19711204 Pitroda AP, Harris SS, Dawson-Hughes B: The association of adiposity with parathyroid hormone in healthy older adults. Endocrine. 2009 Oct;36(2):218-23. Epub 2009 Aug 27.

The variables that we examined, including plasma 25-hydroxyvitamin D and serum osteocalcin, calcium, phosphorus, and insulin explained only a small proportion of this association (18%).
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19384847 Almaden Y, Rodriguez-Ortiz ME, Canalejo A, Canadillas S, Canalejo R, Martin D, Aguilera-Tejero E, Rodriguez M: Calcimimetics normalize the phosphate-induced stimulation of PTH secretion in vivo and in vitro. J Nephrol. 2009 Mar-Apr;22(2):281-8.

Thus, calcimimetics should be effective in patients with secondary hyperparathyroidism whose phosphorus levels would contraindicate vitamin D treatment alone.
Calcimimetics are therapeutic drugs demonstrated to lower parathyroid hormone (PTH) levels through an increase in the intracellular calcium of parathyroid cells.
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19569031 Tsagalis G, Psimenou E, Manios E, Laggouranis A: Fibroblast growth factor 23 (FGF23) and the kidney. . Int J Artif Organs. 2009 Apr;32(4):232-9.


Among the latter, parathyroid hormone (PTh), and vitamin D3 (Vit D3) were thought to be the main regulators of serum phosphate concentration since they mediated the intestinal, renal and bone responses that follow fluctuations in serum phosphate levels.
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20090879 Jadoul M, Banos A, Zani VJ, Hercz G: The effects of discontinuing cinacalcet at the time of kidney transplantation. NDT Plus. 2010 Feb;3(1):37-41. Epub 2009 Dec 4.


Post-kidney transplant, there were no obvious differences between the two groups in levels of serum intact parathyroid hormone, calcium or phosphorus.
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19339410 Bugeja A, Dacouris N, Thomas A, Marticorena R, McFarlane P, Donnelly S, Goldstein M: In-center nocturnal hemodialysis: another option in the management of chronic kidney disease. Clin J Am Soc Nephrol. 2009 Apr;4(4):778-83. Epub 2009 Apr 1.


RESULTS: After conversion to INHD, median values for phosphorus decreased from 5.9 to 3.7 mg/dl (P < 0.01), alkaline phosphatase level increased from 84 to 161 U/L (P < 0.01), and percentage reduction in urea increased from 74 to 89% (P < 0.01).
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19571528 Premaor MO, Scalco R, da Silva MJ, Furlanetto TW: Secondary hyperparathyroidism is associated with increased risk of hospitalization or death in elderly adults living in a geriatric institution. Gerontology. 2009;55(4):405-10. Epub 2009 Jul 2.

Serum levels of 25-hydroxyvitamin D [25 (OH) D], parathyroid hormone (PTH), albumin, total calcium, phosphorus, magnesium, creatinine and alkaline phosphatase were measured.
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19596163 Fishbane S, Chittineni H, Packman M, Dutka P, Ali N, Durie N: Oral paricalcitol in the treatment of patients with CKD and proteinuria: a randomized trial. Am J Kidney Dis. 2009 Oct;54(4):647-52. Epub 2009 Jul 12.

Every 4 weeks, there was measurement of serum intact parathyroid hormone, serum calcium, serum phosphorus, serum creatinine, and urine spot protein and creatinine.
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19760629 Isahaya E, Hara N, Nishiyama T, Hoshii T, Takizawa I, Takahashi K: Bone metabolic disorder in patients with prostate cancer receiving androgen deprivation therapy (ADT): impact of ADT on the growth hormone/insulin-like growth factor-1/parathyroid hormone axis. Prostate. 2010 Feb 1;70(2):155-61.

Bone resorption markers such as blood N-telopeptide (NTx), urinary NTx, calcium, and inorganic phosphorus levels increased after ADT (P < 0.001 in all).
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19404704 Conti-Freitas LC, Foss-Freitas MC, Lucca LJ, da Costa JA, Mamede RC, Foss MC: Dynamics of parathyroid hormone secretion after total parathyroidectomy and autotransplantation. World J Surg. 2009 Jul;33(7):1403-7.

RESULTS: In RP, there was a decrease in the average serum levels of PTH, phosphorus, and alkaline phosphatase, which ranged from 13 to 231 (87 +/- 65) pg/ml, 2.3 to 6.2 (3.3 +/- 1.1) mg/dl, and 77 to 504 (250 +/- 135) U/L, respectively, similar to that observed in LP.
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19781123 Kemi VE, Karkkainen MU, Rita HJ, Laaksonen MM, Outila TA, Lamberg-Allardt CJ: Low calcium:phosphorus ratio in habitual diets affects serum parathyroid hormone concentration and calcium metabolism in healthy women with adequate calcium intake. Br J Nutr. 2010 Feb;103(4):561-8. Epub 2009 Sep 28.

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20200995 Weber K, Zeitz U, Bergow C, Hirmer S, Schuler C, Erben RG: Vitamin D Independent Therapeutic Effects of Extracellular Calcium in a Mouse Model of Adult-Onset Secondary Hyperparathyroidism. J Bone Miner Res. 2009 Dec 14:1-41.

Cell proliferation and parathyroid hormone secretion in the parathyroid gland are known to be regulated by vitamin D and by extracellular calcium.
Wild-type and homozygous VDR mutant mice were kept on a rescue diet (RD) containing 2% calcium (Ca), 1.25% phosphorus (P), and 20% lactose until they were 4 months or 1 year of age.
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19696213 Sprague SM, Evenepoel P, Curzi MP, Gonzalez MT, Husserl FE, Kopyt N, Sterling LR, Mix C, Wong G: Simultaneous control of PTH and CaxP Is sustained over three years of treatment with cinacalcet HCl. Clin J Am Soc Nephrol. 2009 Sep;4(9):1465-76. Epub 2009 Aug 20.

SHPT is a progressive disease often requiring long-term therapy to control parathyroid hormone (PTH) and mineral imbalances.
Vitamin D sterols and phosphate binders, used as traditional therapies to lower PTH and phosphorus, may provide inadequate long-term control for many dialysis patients.
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19308412 Gaal J, Bender T, Varga J, Horvath I, Kiss J, Somogyi P, Suranyi P: Overcoming resistance to bisphosphonates through the administration of alfacalcidol: results of a 1-year, open follow-up study. Rheumatol Int. 2009 Mar 24.

However, the serum alkaline phosphatase activity, phosphorus, parathormone, osteocalcin levels and the urinary D: -pyr/creatinine ratio decreased significantly (P < 0.001).
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19949274 Uenishi K: [Phosphorus intake and bone health] . Clin Calcium. 2009 Dec;19(12):1822-8.

It has been reported that parathyroid hormone and bone resorption markers are increased in case of low calcium/phosphorus intake ratio.
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20301083 Lomonte C, Derosa C, Vernaglione L, Casucci F, Losurdo N, Libutti P, Teutonico A, Basile C: Serum parathyroid hormone and phosphate influence the levels of circulating CD34+ cells in uremia. J Nephrol. 2010 Mar 18. pii: 8A13134E-146D-475D-8FDC-866EB2E16427.

Serum PTH, calcium (Ca), phosphorus (P), alkaline phosphatases (ALP), urea nitrogen, albumin and hemoglobin were measured.
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20175051 Lomonte C, Casucci F, Libutti P, Losurdo N, Teutonico A, Basile C: Vitamin D treatment in hemodialysis patients with low serum levels of parathyroid hormone: which is the best choice?. J Nephrol. 2010 Mar-Apr;23(2):210-5.

Results: Group A showed a statistically significant increase in the serum levels of calcium corrected for serum albumin (cCa), phosphorus (P), total alkaline phosphatases (ALP), PTH and 25 (OH) D.
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19587496 Hamidian Jahromi A, Roozbeh J, Raiss-Jalali GA, Dabaghmanesh A, Jalaeian H, Bahador A, Nikeghbalian S, Salehipour M, Salahi H, Malek-Hosseini A: Risk factors of post renal transplant hyperparathyroidism. . Saudi J Kidney Dis Transpl. 2009 Jul;20(4):573-6.

In most patients, a decrease in parathyroid hormone (PTH) occurs by about 1 year after renal transplantation.
The duration of dialysis, calcium (Ca), phosphorus (P), albumin, creatinine and iPTH levels were recorded prior to transplantation and three months and one year after transplantation.
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19587504 El Kossi M, Rana A, El Nahas M: Risk factors of hyperparathyroidism in advanced stages of chronic kidney disease. Saudi J Kidney Dis Transpl. 2009 Jul;20(4):623-7.

We evaluate in this study the potential effect of demographic and biochemical markers on parathormone (PTH) level in patients with chronic kidney disease (CKD) stages 4 and 5.
All patients had baseline as well as follow-up levels of PTH, adjusted serum calcium, phosphate, calcium phosphorus product, albumin, bicarbonate and estimated glomerular filtration rate (eGFR).
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19765254 Nakai K, Komaba H, Fukagawa M: Management of mineral and bone disorder in chronic kidney disease: quo vadis?. Ther Apher Dial. 2009 Oct;13 Suppl 1:S2-6.

This is in contrast to vitamin D analogs that inhibit parathyroid hormone secretion at the price of enhanced intestinal absorption of calcium and phosphorus.
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19917360 Gorgulu N, Yelken B, Caliskan Y, Elitok A, Cimen O, Yazici H, Oflaz H, Turkmen A, Bozfakioglu S, Sever MS: Endothelial dysfunction in peritoneal dialysis patients with and without failed renal transplants. Transplant Proc. 2009 Nov;41(9):3647-50.

Serum creatinine, calcium, phosphorus, total cholesterol, albumin, hemoglobin, and intact parathyroid hormone (iPTH) were measured.
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20172446 Bomback AS, Kshirsagar AV, Whaley-Connell AT, Chen SC, Li S, Klemmer PJ, McCullough PA, Bakris GL: Racial differences in kidney function among individuals with obesity and metabolic syndrome: results from the Kidney Early Evaluation Program (KEEP). Am J Kidney Dis. 2010 Mar;55(3 Suppl 2):S4-S14.

METHODS: 3 study cohorts were assembled: (1) eligible African American and white KEEP participants with body mass index > or = 30 kg/m (2), (2) a subgroup meeting criteria for metabolic syndrome, and (3) a subgroup with eGFR < 60 mL/min/1.73 m (2) and laboratory measurements for hemoglobin, parathyroid hormone, calcium, and phosphorus.
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19524874 Benhammou A, Meziane M, Dib N, Nazih N, Boulaadas M, Essakali L, Kzadri M: [Maxilla-mandibular brown tumors as a first sign of parathyroid adenoma] . Ann Otolaryngol Chir Cervicofac. 2009 Sep;126(4):216-20. Epub 2009 Jun 13.


The phosphocalcic metabolism was disturbed and the parathormone rate was high.
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19306981 Kirdak T, Duh QY, Kebebew E, Clark OH: Do patients undergoing parathyroidectomy for primary hyperparathyroidism in San Francisco, CA, and Bursa, Turkey, differ?. Am J Surg. 2009 Aug;198(2):188-92. Epub 2009 Mar 23.


Serum parathyroid hormone levels were higher in Turkish group (546 +/- 75.33 pg/mL) than in American group (146 +/- 75.33 pg/mL).
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19285609 Bhuriya R, Li S, Chen SC, McCullough PA, Bakris GL: Plasma parathyroid hormone level and prevalent cardiovascular disease in CKD stages 3 and 4: an analysis from the Kidney Early Evaluation Program (KEEP). Am J Kidney Dis. 2009 Apr;53(4 Suppl 4):S3-10.

Age, hemoglobin level, estimated glomerular filtration rate, serum phosphorus level, and serum calcium level were evaluated as continuous variables, and plasma PTH levels, by tertile: less than 35, 35 to 70, and greater than 70 pg/mL.
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19329828 Inaba M: [Chronic kidney disease (CKD) and bone. Clin Calcium. 2009 Apr;19(4):502-7.


Diabetes directly impairs osetoblasts to decrease bone mass, suppresses bone turnover to impair bone quality by impairing secretion of parathyroid hormone and increase AGE-modification of bone collagen.
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19483275 Goto S, Fukagawa M: [Clinical aspect of recent progress in phosphate metabolism. Clin Calcium. 2009 Jun;19(6):809-14.


Phosphate retention, decreasing 1,25-dihydroxyvitamin D3, and hypocalcemia with kidney dysfunction stimulate the secretion of parathyroid hormone.
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20091482 Caudrillier A, Mentaverri R, Brazier M, Kamel S, Massy ZA: Calcium-sensing receptor as a potential modulator of vascular calcification in chronic kidney disease. J Nephrol. 2010 Jan-Feb;23(1):17-22.

Calcimimetics have been demonstrated to be particularly useful to control parathyroid hormone (PTH) oversecretion and concomitantly reduce serum Ca2+ and phosphorus levels in dialysis patients.
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19640383 Liu YL, Wang SM, Lin HH, Wang IK, Kuo HL, Yang YF, Liu JH, Chou CY, Yeh HC, Ting IW, Tsai CA, Huang CC: The relationship between chronic hepatitis B infection and bone mineral, metabolism in peritoneal dialysis patients. Clin Nephrol. 2009 Jul;72(1):15-20.

PATIENTS AND METHODS: Serum calcium [adj], phosphorus, calcium and phosphorus product (Ca x P), along with intact parathyroid hormone (iPTH) levels were compared in peritoneal dialysis patients with and without chronic hepatitis B infection.
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20073162 Olivero JJ, Nguyen PT, Olivero JJ: Chronic kidney disease: a marker of cardiovascular disease. . Methodist Debakey Cardiovasc J. 2009;5(2):24-9.

Multiple factors contribute to CVD in CKD patients, including hypertension, anemia, inflammation, hyperlipidemia, calcium-phosphorus-parathyroid hormone imbalance, and hyperuricemia.
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19379176 Yajima I, Tanizawa T, Yamamoto N, Fukuda T, Higashi T, Tabata S, Yao R, Yamato H, Murayama H: A case report of a bone histomorphometrical analysis after a total parathyroidectomy. Ther Apher Dial. 2009 Feb;13(1):83-7.

He had been administered calcium carbonate 6.0 g daily to prevent reabsorption of phosphorus and alfacalcidol 1.0 microg three times weekly at the end of hemodialysis.
In September 2000, his intact parathyroid hormone (iPTH; 1-84 PTH) was 610 pg/mL; therefore, from 2.5 microg to 10 microg 22-oxacalcitriol (maxacalcitol, a derivative of active vitamin D) was administered intravenously three times weekly at the end of hemodialysis.
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19800639 Saab G, Whaley-Connell A, McFarlane SI, Li S, Chen SC, Sowers JR, McCullough PA, Bakris GL: Obesity is associated with increased parathyroid hormone levels independent of glomerular filtration rate in chronic kidney disease. Metabolism. 2010 Mar;59(3):385-9. Epub 2009 Oct 2.

After adjustment for age, race, sex, diabetes, calcium, phosphorus, estimated glomerular filtration rate, and presence of microalbuminuria, PTH levels were 7.3% (P = .008), 11.9% (P < .0001), and 18.1% (P < .0001) higher in the second, third, and fourth BMI quartiles, respectively, as compared with the first quartile.
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19548062 Yano S, Suzuki K, Sumi M, Tokumoto A, Shigeno K, Himeno Y, Sugimoto T: Bone metabolism after cinacalcet administration in patients with secondary hyperparathyroidism. J Bone Miner Metab. 2010;28(1):49-54. Epub 2009 Jun 23.


Cinacalcet, an allosteric modulator of a calcium (Ca)-sensing receptor, significantly suppresses parathyroid hormone (PTH) secretion and bone turnover rate in chronic hemodialysis (HD) patients with secondary hyperparathyroidism (SHPT).
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20061700 Souqiyyeh MZ, Shaheen FA: Survey of attitudes of physicians toward the current evaluation and treatment of chronic kidney disease-mineral and bone disorder (CKD-MBD). Saudi J Kidney Dis Transpl. 2010 Jan;21(1):93-101.

There were 84 respondents (54%) who believed that the parathormone (PTH) blood levels initially increase at a glomerular filtration rate (GFR) < 30%.
There were 80 (53%) respondents who believed that changes of phosphorus (PO4) and calcium (Ca) blood levels are initially observed at GFR < 30 mL/min.
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19371801 Patel TV, Singh AK: Kidney disease outcomes quality initiative guidelines for bone and mineral metabolism: emerging questions. Semin Nephrol. 2009 Mar;29(2):105-12.

In the past 5 years, with the publication of several randomized controlled trials, large observational studies, and smaller clinical series, significant progress has been made in our understanding of mineral metabolism, calcium and phosphorus management, and the use of activated vitamin D irrespective of parathyroid hormone level in chronic kidney disease.
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19539186 Smith DH, Johnson ES, Thorp ML, Yang X: Adherence to K/DOQI bone metabolism guidelines. J Ren Nutr. 2009 Jul;19(4):334-42.

OBJECTIVE: Guidelines for the treatment of patients with chronic kidney disease recommend laboratory testing of markers of bone metabolism, including intact parathyroid hormone, calcium, and phosphorus.
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19369690 Urena P, Jacobson SH, Zitt E, Vervloet M, Malberti F, Ashman N, Leavey S, Rix M, Os I, Saha H, Ryba M, Bencova V, Banos A, Zani V, Fouque D: Cinacalcet and achievement of the NKF/K-DOQI recommended target values for bone and mineral metabolism in real-world clinical practice--the ECHO observational study. Nephrol Dial Transplant. 2009 Sep;24(9):2852-9. Epub 2009 Apr 15.

The patients generally had severely uncontrolled intact parathyroid hormone (iPTH) serum levels (median 721 pg/ml) and elevated phosphorus (median 5.9 mg/dl) and calcium (median 9.6 mg/dl) at baseline, despite being prescribed conventional therapies.
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19844134 Dagli CE, Sayarlioglu H, Dogan E, Acar G, Demirpolat G, Ozer A, Koksal N, Gelen ME, Atilla N, Tanrikulu AC, Isik IO, Ugur T: Prevalence of and Factors Affecting Pulmonary Hypertension in Hemodialysis Patients. Respiration. 2009 Oct 21;78(4):411-415.

Blood tests including arterial blood gases, hemoglobin, serum calcium, phosphorus and parathyroid hormone were determined.
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20176609 Nasrallah MM, El-Shehaby AR, Salem MM, Osman NA, El Sheikh E, Sharaf El Din UA: Fibroblast growth factor-23 (FGF-23) is independently correlated to aortic calcification in haemodialysis patients. Nephrol Dial Transplant. 2010 Feb 22.

Intact FGF-23, parathormone, lipids, calcium and phosphorus were measured.
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19731978 Walker Harris V, Jan De Beur S: Postoperative hypoparathyroidism: medical and surgical therapeutic options. Thyroid. 2009 Sep;19(9):967-73.

BACKGROUND: Hypoparathyroidism occurs when the parathyroid glands, through lack of secretion of or resistance to parathyroid hormone (PTH), are unable to maintain calcium homeostasis.
SUMMARY: Although strategies for treatment of transient and permanent hypoparathyroidism differ, the classical approach involves supplementation with calcium and vitamin D or its analogues with the major goal of achieving low normal serum calcium and normal serum phosphorus.
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19765255 Kakuta T, Tanaka R, Kanai G, Sawaya A, Hirukawa T, Sato A, Saito A: Can cinacalcet replace parathyroid intervention in severe secondary hyperparathyroidism?. Ther Apher Dial. 2009 Oct;13 Suppl 1:S20-7.

Thirty-seven patients had baseline intact parathyroid hormone (iPTH) levels of > 500 pg/mL, but only five still had levels this high after 6-month cinacalcet therapy.
No patients had phosphorus (P), calcium (Ca), or iPTH levels within the target range at baseline, but six patients (9.8%) reached all three target ranges after treatment.
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20211333 Akat K, Kaden JJ, Schmitz F, Ewering S, Anton A, Klomfass S, Hoffmann R, Ortlepp JR: Calcium metabolism in adults with severe aortic valve stenosis and preserved renal function. Am J Cardiol. 2010 Mar 15;105(6):862-4.

To further investigate this, the following parameters were analyzed in 38 patients with severe AS and in 38 age- and gender-matched controls, without obstructive coronary artery disease and with preserved renal function: calcium, phosphate, 1,25 (OH (2))-vitamin D (3), intact parathyroid hormone (iPTH), and osteoprotegerin.
Patients with AS had significantly higher serum levels of calcium (2.63 +/- 0.28 vs 2.48 +/- 0.23 mmol/L, p <0.01) and phosphate (1.56 +/- 0.33 vs 1.38 +/- 0.26 mmol/L, p <0.01) and increased calcium-phosphorus products (4.16 +/- 1.13 vs 3.44 +/- 0.89 mmol/L (2), p = 0.003).
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19470383 Henley C, Davis J, Miller G, Shatzen E, Cattley R, Li X, Martin D, Yao W, Lane N, Shalhoub V: The calcimimetic AMG 641 abrogates parathyroid hyperplasia, bone and vascular calcification abnormalities in uremic rats. Eur J Pharmacol. 2009 Aug 15;616(1-3):306-13. Epub 2009 May 24.

Calcimimetics and vitamin D sterols reduce serum parathyroid hormone (PTH) in patients with secondary hyperparathyroidism receiving dialysis, a disease state associated with parathyroid hyperplasia, vascular calcification, bone disease, and increased mortality.
AMG 641 significantly reduced calcium-phosphorus product (CaxP) and significantly attenuated the development of both parathyroid hyperplasia and vascular calcification.
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19355939 Theman TA, Collins MT: The role of the calcium-sensing receptor in bone biology and pathophysiology. Curr Pharm Biotechnol. 2009 Apr;10(3):289-301.

The identification of the calcium-sensing receptor (CaR) in parathyroid glands as the master regulator of parathyroid hormone (PTH) secretion proved that cells could specifically respond to changes in divalent cation concentration.
Complex endocrine feedback loops involving calcium, phosphorus, vitamin D, and PTH confound efforts to isolate the effects of a single mineral, hormone, or receptor and most models fail to account for other local factors such as parathyroid hormone related protein (PTHrP).
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20347976 Posner GH, Helvig C, Cuerrier D, Collop D, Kharebov A, Ryder K, Epps T, Petkovich M: Vitamin D Analogues Targeting CYP24 in Chronic Kidney Disease. . J Steroid Biochem Mol Biol. 2010 Mar 26.


In vivo studies demonstrate that CTA091 decreases serum intact parathyroid hormone (iPTH) levels and increases circulating 1alpha,25 (OH)(2) D (3).
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19715930 Lopez V, Toledo R, Sola E, Gutierrez C, Sujan S, Rodriguez MA, Cabello M, Burgos D, Gonzalez Molina M, Hernandez D: Treatment with cinacalcet in 29 kidney transplant patients with persistent hyperparathyroidism. Transplant Proc. 2009 Jul-Aug;41(6):2394-5.

RESULTS: Treatment with cinacalcet effectively reduced levels of calcium (baseline, 11.1 +/- 0.8 vs 9.7 +/- 0.6 mg/dL at 12 months; P < .05) and intact parathyroid hormone (iPTH; baseline, 288 +/- 155 vs 236 +/- 118 pg/mL at 12 months; P = NS).
Phosphorus levels increased from 2.5 +/- 0.6 to 3.2 +/- 0.8 mg/dL (P < .05).
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19396314 Carrillo-Lopez N, Fernandez-Martin JL, Cannata-Andia JB: [The role of calcium, calcitriol and their receptors in parathyroid regulation]. Nefrologia. 2009;29(2):103-8. doi: 10.3265/Nefrologia.2009.29.2.5154.en.full.

The mechanism of regulation of Parathyroid hormone (PTH) is complex, and diverse factors are involved: the fundamental ones are calcium, calcitriol and phosphorus.
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19560849 Giannikopoulos G, Zorzou MP, Stamoulis I, Panagi G, Sitaras P, Georgopoulos I, Hadjileontis C, Malakos I, Kyriazis J: Cinacalcet-induced leukocytoclastic vasculitis. . Am J Kidney Dis. 2009 Aug;54(2):e5-8. Epub 2009 Jun 28.

Cinacalcet targets the calcium-sensing receptor and decreases parathyroid hormone levels without increasing calcium and phosphorus levels.
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19323936 Li H, Wang SX, Wang W, Xu C, Shen S, Yu L, Zhang GZ: Thrombosis of the superior vena cava and auxiliary branches in patients with indwelling catheterization of the internal jugular vein. Chin Med J. 2009 Mar 20;122(6):692-6.

Collected were data on age, gender, ultrafiltration volume, Kt/V, blood pressure, levels of hemoglobin, serum albumin, lipid, calcium, and phosphorus, and parathyroid hormone.
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19463763 Goldsmith D, Kothawala P, Chalian A, Bernal M, Robbins S, Covic A: Systematic review of the evidence underlying the association between mineral metabolism disturbances and risk of fracture and need for parathyroidectomy in CKD. Am J Kidney Dis. 2009 Jun;53(6):1002-13.

PREDICTOR: Mineral metabolism variables (phosphorus, calcium, and parathyroid hormone [PTH] levels).
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19302594 Terai K, Nara H, Takakura K, Mizukami K, Sanagi M, Fukushima S, Fujimori A, Itoh H, Okada M: Vascular calcification and secondary hyperparathyroidism of severe chronic kidney disease and its relation to serum phosphate and calcium levels. Br J Pharmacol. 2009 Apr;156(8):1267-78. Epub 2009 Mar 19.

Serum calcium, phosphate and parathyroid hormone were measured and calcification in aorta was assessed histologically.
The effects of varying phosphorus content of diet or treatment with phosphate binders or active vitamin D (3) on these parameters were examined.
1(0,0,0,1) Details
19601862 Brancaccio D, Bellasi A, Cozzolino M, Galassi A, Gallieni M: Arterial accelerated aging in dialysis patients: the clinical impact of vascular calcification. Curr Vasc Pharmacol. 2009 Jul;7(3):374-80.


Indeed, careful control of calcium load, serum P and parathyroid hormone along with the use of calcium-free P binders and vitamin D analogs represent our current armamentarium to improve quality of life and reduce mortality in CKD.
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19299893 Taylor JG, Bushinsky DA: Calcium and phosphorus homeostasis. Blood Purif. 2009;27(4):387-94. Epub 2009 Mar 23.

In addition to parathyroid hormone and vitamin D, recently identified factors such as fibroblast growth factors and klotho play an important role in maintaining mineral ion homeostasis.
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19396320 Rodrigo Calabia E, Ruiz San Millan JC, Gago M, Ruiz Criado J, Pinera Haces C, Fernandez Fresnedo G, Palomar R, Gomez Alamillo C, Martin de Francisco AL, Arias M: [Changes in the pre-transplant bone-mineral metabolism do not affect the initial progress of the renal graft]. Nefrologia. 2009;29(2):143-9. doi: 10.3265/Nefrologia.2009.29.2.5006.en.full.

CONCLUSIONS: In our study population pretransplant serum PTH, calcium and phosphorus levels have no influence on the risk for DGF.
BACKGROUND: Abnormalities in serum calcium, phosphate, and Parathyroid Hormone (PTH) concentrations are common in patients with chronic kidney disease and have been associated with increased morbidity and mortality.
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19295198 Nikolov IG, Mozar A, Drueke TB, Massy ZA: Impact of disturbances of calcium and phosphate metabolism on vascular calcification and clinical outcomes in patients with chronic kidney disease. Blood Purif. 2009;27(4):350-9. Epub 2009 Mar 18.

Hypercalcemia and hyperphosphatemia have long been known to play a major role in the occurrence of vascular and other soft tissue calcification in patients with CKD, together with endocrine disturbances including vitamin D, parathyroid hormone, fibroblast growth factor-23, and klotho.
It remains to be demonstrated in prospective randomized trials whether normalization of serum phosphorus and/or calcium leads to better patient outcome.
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19298641 Abdul Gafor AH, Saidin R, Loo CY, Mohd R, Zainudin S, Shah SA, Norella KC: Intravenous calcitriol versus paricalcitol in haemodialysis patients with severe secondary hyperparathyroidism. Nephrology. 2009 Aug;14(5):488-92. Epub 2009 Mar 10.

Intensive treatment with calcitriol is often complicated by hypercalcaemia, hyperphosphataemia and elevated calcium phosphorus (Ca X PO (4)) product.
The study objectives were to compare the response of intact parathyroid hormone (iPTH) and the incidence of hypercalcaemia, hyperphosphataemia and elevated Ca X PO (4) product in patients with severe SHPT treated with either i.v. calcitriol or i.v. paricalcitol.
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19554054 Roca-Tey R, Paez R, Rivas A, Samon R, Ibrik O, Gimenez I, Viladoms J: [Prevalence and functional effect of arteriovenous fistula calcifications, evaluated by spiral CT in chronic haemodialysis patients]. Nefrologia. 2009;29(3):214-21. doi: 10.3265/Nefrologia.2009.29.3.5103.en.full.

Laboratory parameters analyzed: calcium, phosphorus, parathyroid hormone; calcium x phosphorus product was calculated.
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19821349 Palmer SC, McGregor DO, Craig JC, Elder G, Macaskill P, Strippoli GF: Vitamin D compounds for people with chronic kidney disease requiring dialysis. Cochrane Database Syst Rev. 2009 Oct 7;(4):CD005633.

BACKGROUND: Clinical guidelines recommend vitamin D compounds to suppress serum parathyroid hormone (PTH) in chronic kidney disease (CKD), however treatment may be associated with increased serum phosphorus and calcium, which are associated with increased mortality in observational studies.
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20308769 Marwaha RK, Tandon N, Agarwal N, Puri S, Agarwal R, Singh S, Mani K: Impact of Two Regimens of Vitamin D Supplementation on Calcium Vitamin D PTH Axis of Schoolgirls of Delhi. Indian Pediatr. 2010 Jan 15. pii: S097475590900056-1.

Outcome measure: Serum 25 (OH) D, calcium, phosphorus, parathyroid hormone, and alkaline phosphatase levels at 6 and 12 months after start of supplementation.
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20056251 Triantafyllou N, Lambrinoudaki I, Armeni E, Evangelopoulos EM, Boufidou F, Antoniou A, Tsivgoulis G: Effect of long-term valproate monotherapy on bone mineral density in adults with epilepsy. J Neurol Sci. 2010 Mar 15;290(1-2):131-4. Epub 2010 Jan 6.

Blood samples were collected for total serum calcium, phosphorus, magnesium, 25-hydroxyvitamin D (3) and parathormone.
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19715931 Torregrosa JV, Bergua C, Martinez de Osaba MJ, Oppenheimer F, Campistol JM: Evolution of secondary hyperparathyroidism after kidney transplantation in patients receiving cinacalcet on dialysis. Transplant Proc. 2009 Jul-Aug;41(6):2396-8.

OBJECTIVE: To evaluate the evolution of calcemia, phosphatemia, and intact parathyroid hormone (iPTH) after KTx in patients with SHPT receiving cinacalcet on dialysis.
Creatinine, calcium, phosphorus, alkaline phosphatase, and iPTH concentrations were evaluated at baseline (day of surgery), at 15 days after surgery, and then monthly for 6 months.
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20053936 Alexander LS, Mahajan A, Odle J, Flann KL, Rhoads RP, Stahl CH: Dietary phosphate restriction decreases stem cell proliferation and subsequent growth potential in neonatal pigs. J Nutr. 2010 Mar;140(3):477-82. Epub 2010 Jan 6.


As expected, PO (4) deficiency resulted in reduced growth (P < 0.05), feed conversion efficiency (P < 0.05), and bone mineral content (P < 0.05), as well as lower plasma concentrations of both PO (4) (P < 0.01) and parathyroid hormone (P < 0.05).
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19685057 Mermerci Baskan B, Pekin Dogan Y, Sivas F, Bodur H, Ozoran K: The relation between osteoporosis and vitamin D levels and disease activity in ankylosing spondylitis. Rheumatol Int. 2010 Jan;30(3):375-81. Epub 2009 Aug 14.


In addition to the routine blood and urine tests, serum 25-(OH) D3, parathormone (PTH), C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), total calcium, ionized calcium, and phosphorous levels of all participants were also measured.
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19411816 Gannage-Yared MH, Abboud B, Amm-Azar M, Saab A, Khalife S, Halaby G, Atallah C, Medlej R, Jambart S: Predictors of intra-operative parathyroid hormone decline in subjects operated for primary hyperparathyroidism by minimally invasive parathyroidectomy. J Endocrinol Invest. 2009 Feb;32(2):160-4.

Serum calcium and phosphorus were measured before surgery and 1 day post-operatively.
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20091488 Cottone S, Palermo A, Arsena R, Riccobene R, Guarneri M, Mule G, Tornese F, Altieri C, Vaccaro F, Previti A, Cerasola G: Relationship of fetuin-A with glomerular filtration rate and endothelial dysfunction in moderate-severe chronic kidney disease. J Nephrol. 2010 Jan-Feb;23(1):62-9.

Multiple regression analysis showed that fetuin-A was independently associated with estimated glomerular filtration rate (beta=0.386; p <0.001), IL-6 (beta=-0.393; p=0.001) and ET-1 (beta=-0.219; p=0.02), in a multivariate model including also sex, parathyroid hormone and the calcium x phosphorus product.
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19648738 Zhou Y, Yu Z, Jia H, Sun F, Ma L, Guo R, Peng L, Cui T: Association between insulin resistance and carotid arterial stiffness in nondiabetic hemodialysis patients. Blood Purif. 2009;28(3):193-9. Epub 2009 Jul 31.

Serum albumin, lipid profile, calcium, phosphorus, intact parathyroid hormone, high-sensitivity C-reactive protein and oxidized low-density lipoprotein (ox-LDL) were also measured.
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19577454 El-Shitany NA, Hegazy S, El-Desoky K: Evidences for antiosteoporotic and selective estrogen receptor modulator activity of silymarin compared with ethinylestradiol in ovariectomized rats. Phytomedicine. 2010 Feb;17(2):116-25. Epub 2009 Jul 3.

Biochemical markers of bone formation (total alkaline phosphatase (ALP), calcium, phosphorus and osteocalcin), endocrinological analysis (estradiol (E2), luteinizing hormone (LH), follicle stimulating hormone (FSH) and parathyroid hormone (PTH)) and serum total cholesterol and total lipids were estimated.
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20062904 Mahdy S, Al-Emadi SA, Khanjar IA, Hammoudeh MM, Sarakbi HA, Siam AM, Abdelrahman MO: Vitamin D status in health care professionals in Qatar. Saudi Med J. 2010 Jan;31(1):74-7.

Serum levels of 25-hydroxyvitamin D (25OHD), parathyroid hormone (PTH), calcium, phosphorus, alkaline phosphatase, total protein, and albumin were obtained.
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20133492 Sprague SM, Coyne D: Control of secondary hyperparathyroidism by vitamin d receptor agonists in chronic kidney disease. Clin J Am Soc Nephrol. 2010 Mar;5(3):512-8. Epub 2010 Feb 4.

In addition, earlier recognition of CKD via estimated GFR and educational efforts have led to advancements in diagnosis and treatment of elevated parathyroid hormone (PTH) and vitamin D deficiency.
VDR agonist therapy should be continuous to ensure continued PTH suppression, coupled with strict monitoring of calcium and phosphorus to ensure compliance within target ranges.
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19925576 Cortadellas O, Fernandez Del Palacio MJ, Talavera J, Bayon A: Calcium and Phosphorus Homeostasis in Dogs with Spontaneous Chronic Kidney Disease at Different Stages of Severity. J Vet Intern Med. 2009 Nov 17.

Methods: Blood and urine samples were obtained for a CBC, biochemistry, determination of parathyroid hormone (PTH), calcitriol, and ionized calcium concentrations and urinalysis.
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19821446 Palmer SC, McGregor DO, Craig JC, Elder G, Macaskill P, Strippoli GF: Vitamin D compounds for people with chronic kidney disease not requiring dialysis. Cochrane Database Syst Rev. 2009 Oct 7;(4):CD008175.

Vitamin D treatment was associated with increased end of treatment serum phosphorus (3 studies, 140 patients: MD 0.37 mg/dL, 95% CI 0.09, 0.66 (0.12 mmol/L, 95% CI 0.03, 0.21)) and serum calcium (5 studies, 184 patients: MD 0.20 mg/dL, 95% CI 0.17 to 0.23 (0.05 mmol/L, 95% CI 0.04 to 0.06)).
BACKGROUND: Vitamin D compounds are used to suppress elevated serum parathyroid hormone (PTH) in people with chronic kidney disease (CKD).
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19695057 Pecovnik-Balon B, Jakopin E, Bevc S, Knehtl M, Gorenjak M: Vitamin D as a novel nontraditional risk factor for mortality in hemodialysis patients. Ther Apher Dial. 2009 Aug;13(4):268-72.

Serum calcium and phosphorus levels were measured by routine laboratory methods.
Parathyroid hormone (PTH) was measured by immunoassay and 25D by enzyme immunoassay.
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20337743 Achinger SG, Mizani MR, Ayus JC: Use of 3-hour daily hemodialysis and paricalcitol in patients with severe secondary hyperparathyroidism: A case series. Hemodial Int. 2010 Mar 10.

We postulated that daily hemodialysis may be effective at controlling parathyroid hormone (PTH) in the setting of severe secondary hyperparathyroidism by improving the control of hyperphosphatemia and allowing increased use of vitamin D analogs.
Additionally, there was an increase in paricalcitol dose from 0 mcg/d to 10.8 (2.00, 11.7) mcg/d, a 39% reduction in calcium x phosphorus product (80.3 +/- 26.8-48.9 +/- 14.0, P <0.01), a 52% reduction in serum phosphorus (9.90 +/- 2.34-4.75 +/- 0.79 mg/dL, P <0.0001), and a 17.6% increase in serum calcium (8.18 +/- 2.04-9.62 +/- 0.93 mg/dL, P <0.01).
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20151157 Cannata-Andia JB, Rodriguez-Garcia M, Roman-Garcia P, Tunon-le Poultel D, Lopez-Hernandez F, Rodriguez-Puyol D: New therapies: calcimimetics, phosphate binders and vitamin D receptor activators. Pediatr Nephrol. 2010 Apr;25(4):609-16. Epub 2010 Feb 12.

New vitamin D receptor activators, such as paricalcitol, are as effective at suppressing parathyroid hormone (PTH) as the traditional vitamin D receptor activators used for the past two decades, but they have a better and safer profile, showing fewer calcaemic and phosphoraemic effects while preserving the desirable effects of the vitamin D receptor activators on the cardiovascular system, hypertension, inflammation and fibrosis.
At present, new compounds are available to treat secondary hyperparathyroidism, namely calcimimetics, novel phosphorus binders and also novel vitamin D receptor activators.
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20200973 Richard C, Huo R, Samadfam R, Bolivar I, Miao D, Brown EM, Hendy GN, Goltzman D: The calcium sensing receptor and 25-hydroxyvitamin D-1alpha-hydroxylase interact to modulate skeletal growth and bone turnover. J Bone Miner Res. 2010 Feb 8.

On a normal diet, all mice were hypocalcemic, with markedly increased parathyroid hormone (PTH), increased trabecular bone volume, increased osteoblast activity, poorly mineralized bone, enlarged and distorted cartilaginous growth plates, and marked growth retardation, especially in the compound mutants.
On a high lactose, high calcium, high phosphorus "rescue" diet, serum calcium, and PTH were normal in the 1alpha (OH) ase (-/-) mice, but increased in the Casr (-/-) 1alpha (OH) ase (-/-) mice with reduced serum phosphorus.
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19476421 Nemerovski CW, Dorsch MP, Simpson RU, Bone HG, Aaronson KD, Bleske BE: Vitamin D and cardiovascular disease. . Pharmacotherapy. 2009 Jun;29(6):691-708.

The hormonal derivative of vitamin D, 1,25-dihydroxyvitamin D (1,25 [OH](2) D) or calcitriol, has been implicated in many physiologic processes beyond calcium and phosphorus homeostasis, and likely plays a role in several chronic disease states, in particular, cardiovascular disease.
Experimental data suggest that 1,25 (OH)(2) D affects cardiac muscle directly, controls parathyroid hormone secretion, regulates the renin-angiotensin-aldosterone system, and modulates the immune system.
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19464927 Byham-Gray L, Drasher T, Deckman K, Graham D, Liftman C, Roberto L, Peiffer P, Denmark R: Effect of aggressive osteodystrophy management on clinical outcomes in stage 5 chronic kidney disease. J Ren Nutr. 2009 Jul;19(4):321-33. Epub 2009 May 23.

OBJECTIVE: The study investigated whether the type of bone disease management (aggressive versus conventional) had an impact on clinical outcomes, namely bone health measures (e.g., biointact parathyroid hormone [BiPTH], serum corrected calcium [cCa] level, serum phosphorus [phos] level, and corrected calcium-phosphorus product [cCaPO (4)]).
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19412643 Vilarrasa N, Gomez JM, Elio I, Gomez-Vaquero C, Masdevall C, Pujol J, Virgili N, Burgos R, Sanchez-Santos R, de Gordejuela AG, Soler J: Evaluation of bone disease in morbidly obese women after gastric bypass and risk factors implicated in bone loss. Obes Surg. 2009 Jul;19(7):860-6. Epub 2009 May 2.

Anthropometric measurements, bone mineral density (BMD) screening using dual-energy X- ray absorptiometry and plasma determinations of calcium, phosphorus, parathyroid hormone (PTH), 25-hydroxyvitamin D [25 (OH) D (3)] and insulin-like growth factor-I (IGF-I) were made prior to and 12 months after surgery.
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19390214 Pires A, Adragao T, Pais MJ, Vinhas J, Ferreira HG: Inferring disease mechanisms from epidemiological data in chronic kidney disease: calcium and phosphorus metabolism. Nephron Clin Pract. 2009;112(3):c137-47. Epub 2009 Apr 24.

METHODS: The measured variables, serum calcitriol, calcidiol, total calcium ([Ca](s)) and phosphorus ([P](s)) and the urinary excretions of calcium and phosphorus, were paired in the same patients with the glomerular filtration rate (GFR) or the serum concentrations of parathormone (i [PTH](s)) (used as independent variables) numerically filtered with a moving average and partitioned into 15-25 frequency classes.
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20347512 Herberth J, Branscum AJ, Mawad H, Cantor T, Monier-Faugere MC, Malluche HH: Intact PTH Combined With the PTH Ratio for Diagnosis of Bone Turnover in Dialysis Patients: A Diagnostic Test Study. Am J Kidney Dis. 2010 Mar 26.

BACKGROUND: Determination of parathyroid hormone (PTH) level is the most commonly used surrogate marker for bone turnover in patients with stage 5 chronic kidney disease on dialysis therapy (CKD-5D).
OTHER MEASUREMENTS: Demographic and treatment-related factors, serum calcium and phosphorus.
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19819110 Portela ML, Monico A, Barahona A, Dupraz H, Sol Gonzales-Chaves MM, Zeni SN: Comparative 25-OH-vitamin D level in institutionalized women older than 65 years from two cities in Spain and Argentina having a similar solar radiation index. Nutrition. 2010 Mar;26(3):283-9. Epub 2009 Oct 9.

OBJECTIVE: The present study evaluated and compared vitamin D nutritional status and calcium-phosphorus metabolism in institutionalized women > 65 y from two cities that have a similar sun irradiation index (heliophany).
A significant inverse correlation between individual 25OHD and parathyroid hormone (PTH) levels was observed in the two groups of women (r=-0.329, P=0.035).
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19857854 Kidder AC, Chew D: Treatment options for hyperphosphatemia in feline CKD: what's out there? . J Feline Med Surg. 2009 Nov;11(11):913-24.

PRACTICAL RELEVANCE: Phosphorus is retained in chronic kidney disease (CKD), promoting renal secondary hyperparathyroidism and eventually resulting in hyperphosphatemia.
CLINICAL SIGNIFICANCE: With careful monitoring of serum phosphate and parathyroid hormone, and implementation of phosphate-restricted dietary management and intestinal phosphate binders, progression of CKD and the degree of hyperparathyroidism in cats may be reduced.
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20024510 Bhatty TA, Riaz K: Calciphylaxis mimicking penile gangrene: a case report. ScientificWorldJournal. 2009 Dec 16;9:1355-9.

The parathyroid hormone (PTH) level is elevated, along with raised calcium phosphorus product.
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19478098 Menon S, Valentini RP, Kapur G, Layfield S, Mattoo TK: Effectiveness of a multidisciplinary clinic in managing children with chronic kidney disease. Clin J Am Soc Nephrol. 2009 Jul;4(7):1170-5. Epub 2009 May 28.

RESULTS: At RRT, patients from the CRI clinic had better hemoglobin, lower parathyroid hormone and calcium phosphorus product than patients followed in the general nephrology clinic.
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19295200 Bover J, Andres E, Lloret MJ, Aguilar A, Ballarin J: Dietary and pharmacological control of calcium and phosphate metabolism in dialysis patients. Blood Purif. 2009;27(4):369-86. Epub 2009 Mar 18.

In this article, we shall consider rational recommendations on the control of calcium, phosphorus and parathyroid hormone while awaiting new evidence.
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19948879 Kan WC, Chien CC, Wu CC, Su SB, Hwang JC, Wang HY: Comparison of low-dose deferoxamine versus standard-dose deferoxamine for treatment of aluminium overload among haemodialysis patients. Nephrol Dial Transplant. 2009 Nov 30.

Serum phosphorus increased in low-dose group (P = 0.029), while plasma intact parathyroid hormone increased in standard-dose group (P = 0.004).
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20122814 Delgado-Andrade C, Seiquer I, Garcia MM, Galdo G, Navarro MP: Increased Maillard reaction products intake reduces phosphorus digestibility in male adolescents. Nutrition. 2010 Jan 30.

Serum phosphorus, parathyroid hormone, and total alkaline phosphatase were determined.
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20308705 Verhave G, Siegert CE: Role of vitamin D in cardiovascular disease. . Neth J Med. 2010 Mar;68(3):113-8.

There is increasing evidence for health benefits accomplished by activated vitamin D through interaction with the vitamin D receptor (VDR) that go beyond calcium and bone homeostasis and regulation of parathyroid hormone (PTH) secretion.
Interestingly, these relations are independent of PTH levels and calcium x phosphorus product.
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19473635 Ito H, Ogata H, Yamamoto M, Takahashi K, Shishido K, Takahashi J, Taguchi S, Kinugasa E: Comparison of oral falecalcitriol and intravenous calcitriol in hemodialysis patients with secondary hyperparathyroidism: a randomized, crossover trial. Clin Nephrol. 2009 Jun;71(6):660-8.


BACKGROUND: Falecalcitriol is a novel vitamin D analog, which has a greater potential to suppress parathyroid hormone (PTH) and a longer half-life.
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19483271 Inoue D: [Clinical aspect of recent progress in phosphate metabolism. Clin Calcium. 2009 Jun;19(6):778-84.

In human body phosphorus is mostly stored with calcium in bone as hydroxyapatite in dynamic equilibrium with the extracellular fluid compartment.
Parathyroid hormone, vitamin D and FGF23 cooperatively maintain homeostasis of the concentrations, product and net balance of calcium and phosphate.
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19563382 Jorgetti V: Review article: Bone biopsy in chronic kidney disease: patient level end-point or just another test?. Nephrology. 2009 Jun;14(4):404-7.

The reduction of renal function in chronic kidney disease leads to disturbed calcium and phosphorus metabolism, impaired action of calcitriol, increased parathyroid hormone, FGF-23 levels and ultimately bone disorders.
The reduction of renal function in chronic kidney disease leads to disturbed calcium and phosphorus metabolism, impaired action of calcitriol, increased parathyroid hormone, FGF-23 levels and ultimately bone disorders.
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19436945 Ohta H, Kuroda T, Onoe Y, Orito S, Ohara M, Kume M, Harada A, Tsugawa N, Okano T, Sasaki S: The impact of lifestyle factors on serum 25-hydroxyvitamin D levels: a cross-sectional study in Japanese women aged 19-25 years. J Bone Miner Metab. 2009;27(6):682-8. Epub 2009 May 14.

Insufficient levels of serum 25-hydroxyvitamin D [25 (OH) D] lead to low bone mineral density (BMD) by increasing serum levels of intact parathyroid hormone (PTH), and are associated with a high mortality rate.
The parameters evaluated in these subjects included: (1) serum concentrations of 25 (OH) D, intact PTH, calcium, and phosphorus; (2) BMD in the lumbar spine and hip; and (3) lifestyle factors (nutrient intake, physical activity, and duration of sunlight exposure).
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