Secondary hyperparathyroidism and target organs in chronic kidney disease.

Secondary hyperparathyroidism (SHPT) is a common disorder in patients with chronic kidney disease (CKD) and is characterized by excessive serum parathyroid hormone (PTH) levels, parathyroid hyperplasia and an imbalance in calcium and phosphorus metabolism. Secondary hyperparathyroidism develops early in the course of CKD and becomes more prominent as kidney function declines.PTH is a major uremic toxin and may be responsible for long-term consequences that include renal osteodystrophy, severe vascular calcifications, alterations in cardiovascular structure and function, immune dysfunction, and anemia. These adverse effects may contribute to an increased risk of cardiovascular morbidity and mortality among end-stage renal failure patients.