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master's thesis
Sekundarni hiperparatireoidizam
Zagreb: University of Zagreb, School of Medicine, 2022. urn:nbn:hr:105:713932
Dropulja, Antonella
University of Zagreb
School of Medicine

Institutional repository: Dr Med - University of Zagreb School of Medicine Digital Repository

Cite this document

Dropulja, A. (2022). Sekundarni hiperparatireoidizam (Master's thesis). Zagreb: University of Zagreb, School of Medicine. Retrieved from https://urn.nsk.hr/urn:nbn:hr:105:713932

Dropulja, Antonella. "Sekundarni hiperparatireoidizam." Master's thesis, University of Zagreb, School of Medicine, 2022. https://urn.nsk.hr/urn:nbn:hr:105:713932

Dropulja, Antonella. "Sekundarni hiperparatireoidizam." Master's thesis, University of Zagreb, School of Medicine, 2022. https://urn.nsk.hr/urn:nbn:hr:105:713932

Dropulja, A. (2022). 'Sekundarni hiperparatireoidizam', Master's thesis, University of Zagreb, School of Medicine, accessed 27 April 2024, https://urn.nsk.hr/urn:nbn:hr:105:713932

Dropulja A. Sekundarni hiperparatireoidizam [Master's thesis]. Zagreb: University of Zagreb, School of Medicine; 2022 [cited 2024 April 27] Available at: https://urn.nsk.hr/urn:nbn:hr:105:713932

A. Dropulja, "Sekundarni hiperparatireoidizam", Master's thesis, University of Zagreb, School of Medicine, Zagreb, 2022. Available at: https://urn.nsk.hr/urn:nbn:hr:105:713932

Metadata
TitleSekundarni hiperparatireoidizam
Title (english)Secondary hyperparathyroidism
AuthorAntonella Dropulja
MentorNikolina Bašić Jukić (mentor)
Committee memberIngrid Prkačin (predsjednik povjerenstva)
Committee memberJasenka Markeljević (član povjerenstva)
Committee memberNikolina Bašić Jukić (član povjerenstva)
GranterUniversity of Zagreb
School of Medicine
Zagreb
Defense date and country2022-09-26, Croatia
Scientific / art field,
discipline and subdiscipline		BIOMEDICINE AND HEALTHCARE
Clinical Medical Sciences
Abstract
Sekundarni hiperparatireoidizam (SHPT) je izazov s kojim se često susrećemo u liječenju bolesnika s kroničnom bubrežnom bolešću (KBB). Poremećena regulacija paratireodnog hormona, vitamina D i receptora za osjet kalcija predstavljaju kritične korake koji dovode do abnormalnosti u metabolizmu minerala: visok sadržaj fosfata, nizak kalcij i manjak vitamina D. Posljedica je hiperplazija paratireodnih žlijezda uz razvoj vaskularnih kalcifikacija. Nove studije su utvrdile središnju ulogu faktora rasta fibroblasta 23 (FGF-23) u regulaciji homeostaze fosfata i vitamina D. Koncentracija FGF-23 raste u kroničnoj bubrežnoj bolesti i pridonosi razvoju hiperparatireoidizma. Postizanje trenutačnih ciljeva za ključne mineralne parametre u upravljaju SHPT-om postavljenim smjernicama za poboljšanje globalnih ishoda bolesti bubrega (KDIGO) može biti izazovno. Ako se loše kontrolira, SHPT napreduje i može dovesti do bolesti kostiju, kalcifikacija mekog tkiva i vaskularnih kalcifikacija, što nepovoljno utječe na mortalitet i morbiditet. Tradicionalne terapije koje ciljaju na razine vitamina D i fosfora nisu bez nedostataka. Pojava kalcimimetika i bolje razumijevanje prednosti i ograničenja prirodnih i aktivnih spojeva vitamina D poboljšali su mogućnosti liječenja pacijenata sa SHPT. Paratireodoktomija je učinkovita kod prikladnih kandidata otpornih na medicinsku terapiju i standard prema kojima bi se trebali određivati novi pristupi. Buduće strategije mogle bi se usredotočiti na stimulaciju apoptotičke aktivnosti hiperplastičnih paratiroidnih stanica.
Abstract (english)
Secondary hyperparathyroidism (SHPT) is a challenge frequently encountered in the management of patients with chronic kidney disease (CKD). Downregulation of the parathyroid hormone, vitamin D and calcium-sensing receptors represent critical steps that lead to abnormalities in mineral metabolism: high phosphate, low calcium, and vitamin D deficiency. These imbalances result in parathyroid hyperplasia and contribute to vascular calcification. New studies have established a central role for fibroblast growth factor 23 (FGF-23) in the regulation of phosphate-vitamin D homeostasis. FGF-23 concentration increases in CKD and contributes to SHPT. Achieving current targets for the key mineral parameters in the management of SHPT set by the Kidney Disease Improving Global Outcomes (KDIGO) guidelines can be challenging. If poorly controlled, SHPT progresses and can lead to bone disease, soft tissue calcification, and vascular calcification, all of which adversely influence morbidity and mortality. Traditional therapies targeting vitamin D and phosphorous levels are not without drawbacks. The emergence of the calcimimetics and a better understanding of the strengths and limitations of native and active vitamin D compounds have improved the treatment options for patients with SHPT. Parathyroidectomy is effective in suitable candidates refractory to medical therapy and the standard against which new approaches should be measured. Future strategies may focus on the stimulation of apoptotic activity of hyperplastic parathyroid cells.
Keywords
Keywords (english)
Languagecroatian
URN:NBNurn:nbn:hr:105:713932
Study programmeTitle: Studies in Nursing
Study programme type: university
Study level: graduate
Academic / professional title: magistar/magistra sestrinstva (magistar/magistra sestrinstva)
Type of resourceText
File originBorn digital
Access conditionsOpen access
Terms of useLicence In copyright icon
Created on2024-03-25 13:42:36