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Hypoparathyroidism, Hyperphosphatemia, hypercalemia

Patient Scenario: Hypoparathyroidism, Hyperphosphatemia & Hypercalcemia

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Assessing the Clinical and Laboratory Parameters

Prior Parathyroidectomy? Low or undetectable PTH levels are an expected finding.

  • 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 remains sensitive to ambient ionized calcium, i.e. is not autonomous


Approximately 3% 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. Very prolonged dialysis times (e.g. daily or nocturnal dialysis) usually achieve better phosphate control, but increased intermittent times up to 5 hours may have little effect

 

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