Hyperparathyroidism of Renal Disease

Perm J. 2016 Summer;20(3):15-127. doi: 10.7812/TPP/15-127.

Noah K Yuen ¹, Shubha Ananthakrishnan ², Michael J Campbell ³

Affiliations

1 Surgical Resident at the University of California, Davis in Sacramento. [email protected].
2 Assistant Professor of Internal Medicine at the University of California, Davis in Sacramento. [email protected].
3 Assistant Professor in the Department of Surgery at the University of California, Davis in Sacramento. [email protected].

Abstract

Renal hyperparathyroidism (rHPT) is a common complication of chronic kidney disease characterized by elevated parathyroid hormone levels secondary to derangements in the homeostasis of calcium, phosphate, and vitamin D. Patients with rHPT experience increased rates of cardiovascular problems and bone disease. The Kidney Disease: Improving Global Outcomes guidelines recommend that screening and management of rHPT be initiated for all patients with chronic kidney disease stage 3 (estimated glomerular filtration rate, < 60 mL/min/1.73 m(2)). Since the 1990s, improving medical management with vitamin D analogs, phosphate binders, and calcimimetic drugs has expanded the treatment options for patients with rHPT, but some patients still require a parathyroidectomy to mitigate the sequelae of this challenging disease.

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