Philip Crepeau, Tatiana Fedorova, Lilah F Morris-Wiseman, Aarti Mathur
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Secondary Hyperparathyroidism and Cognitive Decline.
Purpose of review: Secondary hyperparathyroidism (SHPT) likely contributes to the high prevalence of cognitive decline found among individuals with end-stage kidney disease (ESKD). Our objective is to critically evaluate the recent literature regarding the association between SHPT and cognitive decline and identify potential mechanisms.
Recent findings: Nine studies assessing the relationship between SHPT and cognition have been published in the last two decades, each showing that elevated parathyroid hormone (PTH) levels were associated with cognitive decline. One also found structural changes within the brain related to SHPT. Additionally, two found that SHPT treatment decreases the risk of cognitive decline in ESKD patients.
Summary: SHPT is associated with cognitive impairment. However, the severity of SHPT associated with these changes and the specific cognitive domains affected remain unclear. Future studies are needed to focus on specific cognitive domains, the trajectory of cognitive decline, and optimal treatment strategies including the impact of kidney transplant and tertiary hyperparathyroidism.
期刊介绍:
Under the guidance of Dr. Dorry Segev, from Johns Hopkins, Current Transplantation Reports will provide an in-depth review of topics covering kidney, liver, and pancreatic transplantation in addition to immunology and composite allografts.We accomplish this aim by inviting international authorities to contribute review articles that emphasize new developments and recently published papers of major importance, highlighted by annotated reference lists. By providing clear, insightful balanced contributions, the journal intends to serve those involved in the field of transplantation.