Genetics and molecular disorders in severe secondary hyperparathyroidism: lessons from rna and microarray studies.

Secondary hyperparathyroidism-related disorders begin in the pre-dialysis period and progressively worsen during dialysis. In a high proportion of cases, therapeutic failure in the control of PTH secretion is related to a late start in medical treatment. This may happen because recovery of the functional control of the parathyroid gland, once some irreversible molecular and genetic changes have occurred, can be only partial. These irreversible changes include promotion of cell proliferation and failure of several pathways affecting the metabolism of DNA, RNA and proteins.