Abstract: 【Abstract】 Objective To study the pathological characteristics in secondary hyperparathyroidism(SHPT) among different clinical factors. Methods Totally 48 patients with end-stage renal disease accepted dialysis and were diagnosed as SHPT in China-Japan friendship hospital during 2009 to 2012. The pathological characteristics of 48 cases were analyzed and compared with different clinical factors through retrospective analysis respectively. The ultrastructure of 8 cases fresh parathyroid in dialysis recipients were examined under electron microscope. Results The expression level of parathyroid had no relation to the cell type of parathyroid 、secondary hemorrhage or calcification and M/F ratio（p＞0.05）. Hemorrhage （70.8%,34/48）and/or calcification （62.5%,30/48）appeared evenly in different level group of patients with secondary hyperparathyroidism. Nodular hyperplasia was the predominant growth pattern （95.8%,46/48）in 48 cases secondary hyperparathyroidism patients who accepted dialysis. The calcification in parathyroid became more extensive as dialysis time prolonged（p＜0.05）. Mitochondria and ribosome in hyperplastic parathyroid cell increased remarkably. Conclusions Parathyroid hemorrhage and/or calcification often appear in dialysis recipients who had SHPT. The extent of calcification in parathyroid correlated with dialysis time. Nodular hyperplasia was the important pathologic basis of refractory SHPT in dialysis recipients with end-stage renal disease. The ultrastructure changes in hyperplastic parathyroid gland indicated high activated state of parathyroid cells.

Key words: Secondary hyperparathyroidism, Nodular hyperplasia, Diffuse hyperplasia, Dialysis