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Hyperparathyroidism, hyperphosphatemia & hypercalcemia

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Assessing the Clinical and Laboratory Parameters

This is a potentially dangerous range of mineral metabolism abnormalities to have.  The high levels of both calcium and phosphate increase the risk of ectopic calcification.  Parathyroid glands appear insensitive to ambient calcium (autonomous).

Approximately 3% of all patients are in this category.

 

Therapeutic options:

 

Dialysis Prescription

Dialysis Prescription

Significant prolongation of dialysis times (nocturnal dialysis) may bring about reduction in phosphate and help control calcium levels. Daily intermittent dialysis up to 5 hours may have little effect. Reducing dialysis calcium from 1.25 – 1.0 mmol/L may temporarily help the hypercalcemia but would not be expected to help the hyperphosphatemia and may worsen the hyperparathyroidism.

 

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