Abnormalities of calcium, phosphorus, PTH and vitamin D contribute to the complex changes observed in bone tissue of these patients. Recent studies have revealed the importance proteins expressed primarily in osteocytes, which directly or indirectly regulate the remodeling of normal and pathological bone tissue. The expression of proteins such as FGF23, DMP1, MEPE, PHEX, sclerostin, RANKL, osteoprotegerin have been little studied in different forms of renal osteodystrophy, especially osteitis fibrosa, a bone manifestation of secondary hyperparathyroidism. Treatment of secondary hyperparathyroidism may be clinical (chemical parathyroidectomy) or surgical, and we have a bank of bone biopsies taken before and after the two treatments. Therefore, the purpose of this study is to study the bone expression by immunohistochemistry, of the proteins previously related correlated with the results of histomorphometric analysis of bone biopsies from patients with secondary hyperparathyroidism before and after parathyroidectomy.
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