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It is widely believed that the main mechanism of hypocalcemia in chronic renal failure is the blunted skeletal response to PTH, probably due to appearance of PTH7-84 or PTHR down-regulation in bone. We indicated that the down-regulation of renal PTHR mRNA could contribute to the development of the skeletal resistance for PTH in CRF rats. In addition, the presence of high circulating levels of non-1-84 PTH fragments (most likely 7-84 PTH) detected by the intact assay and the 1-84 PTH explain the need of high levels of intact PTH to prevent adynamic bone disease.
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