The locomotor system
C. Simon Herrington in Muir's Textbook of Pathology, 2020
Parathyroid hormone is important in the regulation of calcium metabolism and bone turnover. It has effects on both osteoblastic and osteoclastic activity. Overactivity of the parathyroid glands is classified as primary, secondary, or tertiary (see Chapter 18). Primary hyperparathyroidism is usually due to the presence of a parathyroid adenoma but in <5% of cases there is diffuse hyperplasia of all four glands, or a parathyroid carcinoma. Primary hyperparathyroidism affects 1 in 1,000 people and is the most common cause of hypercalcaemia in asymptomatic individuals. Early diagnosis due to routine measurement of serum calcium means that bone disease is now found in <5% of cases. In secondary hyperparathyroidism there is parathyroid gland hyperplasia and increased PTH secretion which occurs as a physiological response to hypocalcaemia. The most common cause of hypocalcaemia is chronic renal failure. Tertiary hyperparathyroidism may occur in longstanding secondary hyperparathyroidism when an autonomous nodule develops in a hyperplastic gland, resulting in hypercalcaemia.
The Internal Milieu Brain and Body
Rolland S. Parker in Concussive Brain Trauma, 2016
Cortisol: Exerts a permissive action for many hormones, in addition to its own direct effects. Cortisol is involved in negative feedback, limiting feedback of its own production at the hypothalamic (CRH) and anterior pituitary levels (ACTH). Parathyroid hormone: Regulates calcium and phosphorus levels.Vasopressin: Regulates serum osmolality by controlling renal water clearance.Mineralocorticoids: Control vascular volume and serum electrolyte (Na+ and K+) concentrations.
Critical Nutrients in Foods of Mediterranean Nations
John J.B. Anderson, Marilyn C. Sparling in The Mediterranean Way of Eating, 2014
Macrominerals, or bulk minerals, should be consumed in fairly sizable amounts each day. These include calcium, phosphorus (as phosphates), magnesium, potassium, sodium, and chloride (anionic form of chlorine). Sulfur (S) is also placed in this category, but practically all sulfur is part of S-containing amino acids and a few other organic molecules. Of the bulk elements, calcium, magnesium, and potassium are commonly low or even deficient in the diets of many in the United States, whereas sodium and phosphate intakes typically are too high. Mediterranean people generally obtain adequate dietary amounts of macrominerals, with the possible exception of calcium. Calcium is illustrated as a common divalent cation (positively charged ion) in Table 3.10. Phosphate, a common anion (negatively charged ion) found in foods, and an essential mineral, is typically consumed in amounts much higher than recommended because of phosphate salts used in food processing (Table 3.10). High phosphate intakes may have adverse effects on health and may be associated with increased morbidity and mortality. The ratio of these two minerals, Ca:P, is significant. Too low a ratio (i.e., low calcium to high phosphate) leads to an increase in parathyroid hormone, which may increase bone mineral loss. Older adults, mainly women, may need calcium supplements when usual intakes are too low, but phosphate supplements virtually are never needed.
Development and validation of a nomogram model for predicting low muscle mass in patients undergoing hemodialysis
Published in Renal Failure, 2023
Rongrong Tian, Liyang Chang, Ying Zhang, Hongmei Zhang
Collection and measurement of samples were performed as previously described [22]. Age, sex, dialysis vintage, primary kidney disease, body mass index (BMI), residual kidney function (RKF), and laboratory data were collected at the time of research recruitment. RKF was defined as a 24-h urine output of more than 200 mL. All laboratory parameters, including hemoglobin and serum concentrations of creatinine [SCr], blood urea nitrogen [BUN], hypersensitive C-reactive protein [hs-CRP], triglyceride [TG], total cholesterol [TCH], serum phosphorus, serum albumin, and total protein, were tested using fasting blood samples collected before dialysis at the midweek session. Intact parathyroid hormone [iPTH] assays were used to determine serum parathyroid hormone concentrations. Single-pool Kt/V for urea was calculated as an indicator of dialysis dose, and normalized protein equivalent of nitrogen appearance (nPNA) was calculated as an indicator of protein metabolism [23].
Progress in the study of nutritional status and selenium in dialysis patients
Published in Annals of Medicine, 2023
Meiran Cao, Shuai Zheng, Wenhua Zhang, Guicai Hu
Hyperparathyroidism is common in end-stage dialysis patients. It has been found that parathyroid hormone plays a key role in the browning of adipose tissue and increased resting energy expenditure in dialysis patients. Cuppari et al. [75] measured resting energy expenditure in dialysis patients with hyperparathyroidism and found that parathyroid hormone was an independent determinant of resting energy expenditure. And the researcher also found that 6 months after surgery in patients with severe hyperparathyroidism, parathyroid hormone levels and the patients’ resting energy expenditure were significantly reduced. Regarding the mechanism by which parathyroid hormone increases resting energy expenditure and adipose tissue browning, Kir et al. [76] found that parathyroid hormone and parathyroid hormone-related protein (PTHrP) in dialysis patients can increase the expression of thermogenic genes, accelerate adipose tissue browning, and increase resting energy expenditure in dialysis patients. In 2022, a retrospective study by Disthabanchong et al. [77] showed that patients with severe hyperparathyroidism had a poorer nutritional status than dialysis patients with normal or moderate hyperparathyroidism.
Parathyroid carcinoma in chronic renal disease – a case series of three patients and review of literature
Published in Acta Chirurgica Belgica, 2023
Vladan Zivaljevic, Rastko Zivic, Nikola Slijepcevic, Matija Buzejic, Dusko Dundjerovic, Jasna Trbojevic Stankovic, Dejan Stojakov, Milan Jovanovic, Ivan Paunovic
Secondary hyperparathyroidism accompanied with parathyroid hyperplasia is common in patients with chronic renal failure. On the other hand, parathyroid carcinoma is an extremely rare entity, even more so in patients with end-stage renal disease (ESRD). Approximately, 1000 cases of parathyroid carcinoma have been reported until now; of which 34 cases were diagnosed in patients with ESRD [1,2]. Seven patients with parathyroid carcinoma and primary hyperparathyroidism underwent surgery at our tertiary referral university hospital in a seven-year period. On the other hand, there were only three cases of parathyroid carcinoma in haemodialysis patients that underwent surgery at our clinic over a period of 19 years [3]. The diagnosis of parathyroid carcinoma is very difficult and relies on a combination of preoperative, intraoperative, and pathohistological findings. Usually in these patients, highly elevated parathyroid hormone (PTH) levels and hyperphosphataemia are accompanied with clinical signs and symptoms, such as bone pain and pruritus.
Related Knowledge Centers
- Bone
- Bone REModeling
- Bone Resorption
- Osteon
- Parathyroid Gland
- Ossification
- Metabolism
- Osteoclast
- Hormone
- Calcium In Biology