Mathematical Models of Parathyroid Gland Biology: Complexity and Clinical Use

Gudrun Schappacher-Tilp; Peter Kotanko; Markus Pirklbauer

doi:10.3389/fneph.2022.893391

Mathematical Models of Parathyroid Gland Biology: Complexity and Clinical Use

Front Nephrol. 2022 May 18:2:893391. doi: 10.3389/fneph.2022.893391. eCollection 2022.

Authors

Gudrun Schappacher-Tilp^{1

2}, Peter Kotanko^{3

4}, Markus Pirklbauer⁵

Affiliations

¹ Department of Electronic Engineering, University of Applied Science FH Joanneum, Graz, Austria.
² Institute for Mathematics and Scientific Computing, University of Graz, Graz, Austria.
³ Renal Research Institute New York, New York, NY, United States.
⁴ Icahn School of Medicine at Mount Sinai, New York, NY, United States.
⁵ Department of Internal Medicine IV - Nephrology and Hypertension, Medical University Innsbruck, Innsbruck, Austria.

Abstract

Altered parathyroid gland biology is a major driver of chronic kidney disease-mineral bone disorder (CKD-MBD) in patients with chronic kidney disease. CKD-MBD is associated with a high risk of vascular calcification and cardiovascular events. A hallmark of CKD-MBD is secondary hyperparathyroidism with increased parathyroid hormone (PTH) synthesis and release and reduced expression of calcium-sensing receptors on the surface of parathyroid cells and eventually hyperplasia of parathyroid gland cells. The KDIGO guidelines strongly recommend the control of PTH in hemodialysis patients. Due to the complexity of parathyroid gland biology, mathematical models have been employed to study the interaction of PTH regulators and PTH plasma concentrations. Here, we present an overview of various model approaches and discuss the impact of different model structures and complexities on the clinical use of these models.

Keywords: Parathyroid gland biology; chronic kidney disease - mineral and bone disorder (CKD-MDB); mathematical models; parathyroid hormone; predictions.

Publication types

Review