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. 2023 Jun;10(2):60-68.
doi: 10.1007/s40472-023-00394-5. Epub 2023 Mar 15.

Secondary Hyperparathyroidism and Cognitive Decline

Philip Crepeau  1 , Tatiana Fedorova  1 , Lilah F Morris-Wiseman  1 , Aarti Mathur  1
Affiliations

Secondary Hyperparathyroidism and Cognitive Decline

Philip Crepeau et al. Curr Transplant Rep. 2023 Jun.

Abstract

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.

Keywords: Chronic kidney disease; Cognitive decline; Dementia; End-stage kidney disease; Parathyroid hormone; Secondary hyperparathyroidism.

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Conflict of interest statement

Conflict of Interest The authors declare no competing interests.

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