Nickan Research Institute Journal of Parathyroid Disease 2345-6558 4 2 2016 04 01 Association of secondary hyperparathyroidism with anemiain patients with end-stage renal disease; a review on currentknowledge 48 53 EN Seyed Seifollah Beladi Mousavi Heshmatollah Shahbazian Mohamad-Reza Tamadon Journal Article End-stage renal disease (ESRD) is one of the most common life-threatening diseases and anemia is a known common and importantcomplication of ESRD which can develop well before the onset of uremic symptoms. Anemia among patients with ESRD is principallydue to reduced renal erythropoietin (EPO) production and if left untreated is associated with several abnormalities includingdeterioration in cardiac function and debilitating symptoms and is also associated with an increased risk of hospitalization, hospitallength of stay and mortality among these patients. Secondary hyperparathyroidism (SHPT) is also a common and unrecognizedcomplication of ESRD which is caused by several changes including hypocalcemia, diminished 1,25-dihydroxyvitamin D levels,hyperphosphatemia, a decrease in the activation of the calcium-sensing receptor in the parathyroid gland, and skeletal resistance to thecalcemic effect of PTH. There are several forms of renal osteodystrophy, including osteitis fibrosa cystica and mixed osteodystrophywhich are largely induced by SHPT. In addition to the renal bone disease, several studies have suggested a significant relationshipbetween SHPT and anemia in ESRD patients. The present article summarizes some of these observations including pathophysiologicmechanisms of anemia due to SHPT, relationship between serum PTH levels and the degree of bone marrow fibrosis and the possiblebeneficial effect of surgical and medical intervention of SHPT on anemia among these patients.