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Hypoparathyroidism, desired phosphate and hypercalcemia

Patient Scenario: Hypoparathyroidism, desired phosphate and hypercalcemia

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Assessing the Clinical and Laboratory Parameters

Was there a prior parathyroidectomy. Low or undetectable PTH levels are an expected finding. Are parathyroids intact (or partially resected/reimplanted  during prior PT surgery)?

  • PTH secretion is suppressed secondary to hypercalcemia and/or use of vitamin D analogues;
  • PT gland may remain sensitive to ambient ionized calcium, i.e. is not autonomous

 


Less than 1% of all patients are in this category.


Dialysis Prescription

Dialysis Prescription

Lowering dialysis calcium from 1.25 to 1.0 mmol/L may temporarily alleviate the hypercalcemia, and restore PTH secretion.


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