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Pathophysiology and therapies of CKD-associated secondary hyperparathyroidism

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Paper Summary

Paperzilla title
How Kidney Disease Messes with Calcium and Phosphate

This review article discusses the increasingly complex pathophysiology of secondary hyperparathyroidism (SHP) in chronic kidney disease (CKD), moving beyond traditional factors to include FGF23, klotho, the phosphate pool, and intestinal dysbiosis. These new insights are leading to a better understanding of CKD-related mineral and bone disorder (CKD-MBD) and paving the way for novel therapies, such as targeting specific phosphate transporters or modifying the gut microbiota, which aim beyond managing elevated PTH levels. This review is supported by a grant from CSL Vifor; authors also declared individual COIs related to various pharmaceutical companies.

Explain Like I'm Five

In chronic kidney disease, the parathyroid glands work extra hard to balance calcium and phosphate, leading to complications like bone problems and heart issues.

Possible Conflicts of Interest

The authors declared various conflicts of interest, including being board members, receiving honoraria, consulting fees, and travel support from pharmaceutical companies. It is mentioned that the paper was published as part of a supplement financially supported by an educational grant from CSL Vifor.

Identified Limitations

Review article summarizing research with varied levels of evidence
This paper is a review article. While the review paper provides a summary of the current understanding of secondary hyperparathyroidism in chronic kidney disease and mentions potential therapeutic options, the strength of evidence for some of the claims needs careful evaluation in light of the original studies cited.

Rating Explanation

This review article provides a thorough overview of a complex topic. It covers the classical understanding of secondary hyperparathyroidism (SHP) and delves into newer research areas, offering potential therapeutic avenues. While not presenting original research, its comprehensive approach and focus on emerging aspects like phosphate pool, FGF23, intestinal dysbiosis and their roles in SHP are valuable for guiding future research and clinical practice. The declared conflicts of interest are duly noted and don't appear to unduly bias the content.

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Topic Hierarchy

Domain: Health Sciences
Field: Medicine
Subfield: Nephrology

File Information

Original Title: Pathophysiology and therapies of CKD-associated secondary hyperparathyroidism
Uploaded: August 25, 2025 at 02:53 PM
Privacy: Public