Defining the optimal parathyroid hormone (PTH) target in chronic kidney disease (CKD) is challenging, especially for bone outcomes, due to the substantial variability in the skeleton's response to PTH. Although PTH hyporesponsiveness is as integral a component of CKD-mineral bone disorder as elevated PTH levels, clinical awareness of this condition is limited. In this review, we will discuss factors and mechanisms contributing to PTH hyporesponsiveness in CKD. This knowledge may provide clues towards a personalized approach to treating secondary hyperparathyroidism in CKD.

中文翻译：

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骨骼甲状旁腺激素反应低下：慢性肾脏病中一个被忽视但与临床相关的现实。

由于骨骼对 PTH 的反应存在很大差异，因此确定慢性肾脏病 (CKD) 的最佳甲状旁腺激素 (PTH) 靶点具有挑战性，尤其是对于骨骼结局而言。尽管 PTH 反应低下与 PTH 水平升高一样是 CKD 矿物质性骨病的一个组成部分，但临床对这种情况的认识有限。在这篇综述中，我们将讨论导致 CKD 中 PTH 反应低下的因素和机制。这些知识可能为治疗 CKD 继发性甲状旁腺功能亢进症的个性化方法提供线索。