Viera Spustová
Disturbances of mineral metabolism are common in chronic kidney disease and secondary hyperparathyroidism is the consequence of these changes. With progressive loss of renal function decreases the number of vitamin D receptors and calcium sensing receptors in parathyroid cells which are resistant to vitamin D and calcium. Hyperphosphatemia directly influences the function and growth of parathyroid cells. Hypocalcemia develops in consequence of phosphate retention, skeletal resistance to calcemic effect of parathyroid hormone and disorders of vitamin D metabolism. As a result of these changes, clinical complications such as renal osteodystrophy, vascular calcifications, disturbances of cardiac structure and function, soft tissue calcifications, immune disorders and renal anemia develope. These complications are the major cause of morbidity and mortality chronic kidney disease patients.