ISSN 2398-2950      

Renal secondary hyperparathyroidism

ffelis
Contributor(s):

Penney Barber

Audrey K Cook

Synonym(s): Rubber jaw, Renal rickets, Renal osteodystrophy


Introduction

  • Excessive production of parathyroid hormone (PTH).
  • Cause: hyperphosphatemia secondary to renal compromise results in formation of complexes with calcium   →   compensatory increased PTH synthesis. Concurrent deficiency in calcitrol (active vitamin D) is involved in the pathogenesis.
  • Signs: pain, facial swelling, osteopenia, pathological fractures, signs of renal failure Kidney: chronic kidney disease.
  • Diagnosis: signs, laboratory tests, radiography.
  • Treatment: manage CRF, attempt to reduce hyperphosphatemia.
  • Prognosis: generally guarded.

Pathogenesis

Etiology

  • Severe renal dysfunction (congenital > acquired).

Predisposing factors

General

  • Age.

Pathophysiology

  • Reduced glomerular filtration    →   reduced phosphorous excretion   →    hyperphosphatemia Hyperphosphatemia    →    soft tissue mineralization   →    lowering of [blood calcium] Blood biochemistry: total calcium.
  • Reduced intestinal absorption of calcium due to defective vitamin D metabolism in CRF   →    hypocalcemia Hypocalcemia.
  • Hypocalcemia   →    hypertrophy of parathyroid glands   →    increased PTH secretion PTH assay.
  • Decreased active vitamin D   →    stimulates PTH secretion.
  • PTH   →    increased osteoclastic activity   →    bone resorption.

Timecourse

  • Weeks to months.

Diagnosis

This article is available in full to registered subscribers

Sign up now to obtain ten tokens to view any ten Vetlexicon articles, images, sounds or videos, or Login

Treatment

This article is available in full to registered subscribers

Sign up now to obtain ten tokens to view any ten Vetlexicon articles, images, sounds or videos, or Login

Outcomes

This article is available in full to registered subscribers

Sign up now to obtain ten tokens to view any ten Vetlexicon articles, images, sounds or videos, or Login

Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Finch N C, Syme H M, Elliott J (2012) Parathyroid hormone concentration in geriatric cats with various degrees of renal function. JAVMA 241 (10), 1326-1335 PubMed.
  • Hostutler R A, DiBartola S P, Chew D J et al (2006) Comparison of the effects of daily and intermittent-dose calcitriol on serum parathyroid hormone and ionized calcium concentrations in normal cats and cats with chronic renal failure. JVIM 20 (6), 1307-1313 PubMed.
  • Barber P J, Rawlings J M, Markwell P J et al (1999) Effect of dietary phosphate restriction on renal secondary hyperparathyroidism in the cat. JSAP 40 (2), 62-70 PubMed.

Can’t find what you’re looking for?

We have an ever growing content library on Vetlexicon so if you ever find we haven't covered something that you need please fill in the form below and let us know!

 
 
 
 

To show you are not a Bot please can you enter the number showing adjacent to this field

 Security code