Which Outcome in Chronic Kidney Disease-Mineral and Bone Disorder Patients?

Dear editor,secondary hyperparathyroidism (shpt) is one the major complications in dialysis patients. hyperphosphatemia, hypocalcemia, low serum vitamin d levels are greatly involved into the physiopathology of shpt in chronic kidney disease (ckd), in which the down-regulation of parathyroid vitamin d receptor (vdr) and calcium sensing receptor (casr) represent a critical step. moreover, new data demonstrate that the fibroblast growth factor 23 (fgf-23) plays an important role in the regulation of calcium-phosphate-vitamin d axis in ckd. thus, new insights into the pathogenesis of shpt give the possibility to have different treatments of this condition in ckd.