继发性甲状旁腺功能亢进(secondary hyperparathyroidism,SHPT)是慢性肾脏病的严重并发症之一。SHPT 的发生发展会继发骨代谢性疾病，血管钙化，心血管疾病等不良并发症以及增加患者死亡率。临床可用骨化三醇治疗SHPT，但存在20%～30%患者对骨化三醇治疗抵抗，研究发现骨化三醇抵抗与FGF23、甲状旁腺大小、维生素D 受体、维生素D 受体基因多态性有关。对此部分患者转换其他药物(帕立骨化醇、西那卡塞)或行甲状旁腺微创消融、手术切除甲状旁腺治疗可获一定疗效，为骨化三醇抵抗的SHPT 患者提供新的治疗手段。

Secondary hyperparathyroidism (SHPT) is one of the serious complications of chronic kidney disease. SHPT may cause other complications such as bone metabolic diseases, vascular calcification and cardiovascular disease, resulting in the increase of mortality rate. Clinically, SHPT can be treated with calcitriol, but insensitivity to calcitriol treatment is found in 20%～30% patients. Calcitriol resistance is possibly related to FGF23 level, parathyroid size, vitamin D receptor and gene polymorphism in vitamin D receptor. Change of oral drugs (paricalcitol or calcimimetics) and parathyroidectomy may achieve better therapeutic effect in these patients.