Secondary Hyperparathyroidism

Pathophysiology and Treatment

Saliba, Wissam MD
El-Haddad, Boutros MD

From Department of Internal Medicine, University of Kansas School of Medicine, Wichita.

Corresponding author: Wissam Saliba, MD, Department of Internal Medicine, University of Kansas School of Medicine, 505 North Rock Road, Apt #1436, Wichita, KS 67206 (E-mail: [email protected])

This article was externally peer reviewed.

Funding: none.

Conflict of interest: none declared.

Submitted 7 February 2007; revised 14 April 2009; accepted 21 April 2009.

Journal of the American Board of Family Medicine 22(5):p 574-581, September-October 2009.

Secondary hyperparathyroidism is a frequently encountered problem in the management of patients with chronic kidney disease (CKD). Its pathophysiology is mainly due to hyperphosphatemia and vitamin D deficiency and resistance. This condition has a high impact on the mortality and morbidity of dialysis patients. Early diagnosis of secondary hyperparathyroidism is crucial in the management of patients with CKD. The treatment remains a challenge for patients and their clinicians. It should include a combination of dietary phosphorus restriction, phosphate binders, vitamin D analogues, and calcimimetics.