Different responses between the upper and the lower parathyroid gland in a state of secondary hyperfunction. A study on chronic renal failure by morphometry and nuclear DNA analysis.

The size of the parathyroid gland and the size, the numerical density and nuclear DNA-content of the parathyroid gland cells were evaluated in chronic renal failure (CRF) and revealed a difference between the upper and the lower glands in the manner of adaptation to a state of long-term hyperfunction, secondary to CRF. The parathyroid gland enlarged as a whole in CRF, an effect more marked in the lower gland, whereas individual parathyroid gland cell enlargement in CRF was mainly seen in the upper gland cells. The numerical density of the lower parathyroid gland cells was higher than that of the upper gland. Nuclear DNA-content of the parathyroid gland cells were increased in CRF and the lower gland tended to show hyperdiploid aneuploidy. These findings are probably related to the fact that parathyroid adenomas occur most often in the lower gland. The higher proliferative activity of the lower parathyroid gland in long-term hyperfunction may explain the higher risk for the lower gland in the occurrence of adenomas.