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A mathematical model of calcium and phosphorus metabolism in two forms of hyperparathyroidism.

dc.contributor.authorRaposo, J
dc.contributor.authorPires, A
dc.contributor.authorYokota, H
dc.contributor.authorFerreira, H
dc.date.accessioned2012-12-20T11:27:25Z
dc.date.available2012-12-20T11:27:25Z
dc.date.issued2012
dc.description.abstractParathyroid hormone (PTH) plays a critical role in calcium and phosphorus metabolism. Interestingly, in two forms of hyperparathyroidism (excessive amount of PTH in the serum), the metabolic disturbances in patients with chronic kidney disease (CKD) significantly differ from those with primary hyperparathyroidism (PHP). Since an intuitive understanding of these PTH-linked regulatory mechanisms are hardly possible, we developed a mathematical model using clinical data (1586 CKD and 40 PHP patients). The model was composed of a set of ordinary differential equations, in which the regulatory mechanism of PTH together with other key factors such as 1,25-Dihydroxyvitamin D (1,25(OH)₂D) and calcium was described in the tissues including bone, the kidney, the serum, and the parathyroid glands. In this model, an increase in PTH was induced by its autonomous production in PHP, while PTH in CKD was elevated by a decrease in feedback inhibition of 1,25(OH)₂D in the serum, as well as an increase in stimulation by phosphorus in the serum. The model-based analysis revealed characteristic differences in the outcomes of hyperparathyroidism in CKD and PHP. The calcium exchange in bone, for instance, was predicted significantly higher in PHP than CKD. Furthermore, we evaluated the observed and predicted responses to the administration of calcimimetics, a recently developed synthetic drug that modulated efficacy of calcium-sensing receptors. The results herein support the notion that the described model would enable us to pose testable hypotheses about the actions of PTH, providing a quantitative analytical tool for evaluating treatment strategies of PHP and CKD.por
dc.identifier.citationEndocrine. 2012 Apr;41(2):309-19por
dc.identifier.issn1559-0100
dc.identifier.urihttp://hdl.handle.net/10400.10/820
dc.language.isoengpor
dc.peerreviewedyespor
dc.publisherSpringer USpor
dc.subjectHyperparathyroidismpor
dc.subjectCalciumpor
dc.subjectPhosphoruspor
dc.subjectAlgorithmspor
dc.titleA mathematical model of calcium and phosphorus metabolism in two forms of hyperparathyroidism.por
dc.typejournal article
dspace.entity.typePublication
oaire.citation.conferencePlaceNew Yorkpor
oaire.citation.endPage319por
oaire.citation.startPage309por
oaire.citation.titleEndocrine: International Journal of Basic and Clinical Endocrinologypor
oaire.citation.volume41por
rcaap.rightsopenAccesspor
rcaap.typearticlepor

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