SECONDARY HYPERPARATHYROIDISM: FEATURES OF COURSE, EFFECT ON CARDIOVASCULAR RISK, AND QUALITY OF LIFE IN PATIENTS WITH CHRONIC KIDNEY DISEASE V STAGE

Katerenchuk I. P., Rustamian S. T.

LITERATURE REVIEWS

Scentific article

The number of patients with end stage renal disease is growing worldwide. Mortality in patients with end stage renal disease remains 10-20 times higher than that in the general population. Based on different epidemiological data, chronic kidney disease affects on average 10% of the population around the world. This is the result of the aging of the population and the increase of civilization diseases such as diabetes, hypertension or obesity. The focus in recent years has thus shifted to optimising the care of these patients during the phase of chronic kidney disease (CKD), before the onset of end stage renal disease. The secondary hyperparathyroidism of chronic renal failure is a result of many factors which result in chronic stimulation of parathyroid hormone secretion and secondary hyperplasia of the parathyroid glands. Renal hyperparathyroidism (rHPT) is a common complication of chronic kidney disease characterized by elevated parathyroid hormone levels secondary to derangements in the homeostasis of calcium, phosphate, and vitamin D. Patients with rHPT experience increased rates of cardiovascular problems and bone disease. Renal HPT leads to a host of bone and cardiovascular problems that ultimately can cause fractures, decreased quality of life, and an increased risk of death. Calcium supplementation, high calcium dialysis, control of plasma phosphate and judicious use of the vitamin D metabolites can, to a large extent, prevent or control the development of secondary hyperparathyroidism. Subtotal parathyroidectomy or total parathyroidectomy with autotransplantation is indicated in certain cases, sometimes on an emergency basis. Prevention of postoperative hypocalcemia requires careful management. Quality of life (QoL) of hemodialysis patients is a major evaluative marker currently measured, while treatment time is a clinical determinant associated with impaired QоL. Treating chronic kidney failure is related to receiving long-term dialysis therapy by patients. Both hemodialysis and peritoneal dialysis significantly change patients’ lives.

chronic kidney disease, secondary hyperparathyroidism, parathyroid hormone, phosphorus-calcium metabolism.

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«Bulletin of problems biology and medicine» Issue 3 (152), 2019 year, 23-26 pages, index UDK 616.61-002:616.12-008.331.1

10.29254/2077-4214-2019-3-152-23-26