About Secondary Hyperparathyroidism (SHPT)

If you have chronic kidney disease (CKD) in Stage 3, Stage 4, or Stage 5, there’s another condition for which you may need treatment. This condition is called secondary hyperparathyroidism (SHPT), which is characterized by increased parathyroid hormone levels. Many people at Stages 3, 4, and 5 of CKD have SHPT or will develop SHPT. If you have CKD, ask your doctor which stage you are in and ask him or her about getting a PTH test.

Stage of CKD How Common is SHPT?
Stage 3
(eGFR=30-59mL/min/1.73m2) 		34%1,2
Stage 4
(eGFR=15-29mL/min/1.73m2) 		74%1,2
Stage 5
(eGFR=<15mL/min/1.73m2) 		Nearly all patients on dialysis (Stage 5) are affected by SHPT1

When kidneys are healthy, they filter waste and help to balance fluids, minerals, and other substances in your body.

When kidney function declines, it can lead to a silent condition (with no symptoms) called secondary hyperparathyroidism (SHPT). SHPT is very common in people in Stages 4 and 5 of CKD. If SHPT is left untreated, there is a greater chance that your bones will become weak and brittle and you could also develop permanent damage to the parathyroid gland.

How SHPT affects parathyroid hormone production

No SHPT (Healthy Parathyroid Glands)

Healthy Parathyroid Glands

Figure 1: The four parathyroid glands produce PTH, which helps to balance calcium and phosphorus levels in the body.

SHPT (with Unhealthy Parathyroid Glands)

Unhealthy Parathyroid Glands

Figure 2: When you have SHPT, the parathyroid glands produce too much parathyroid hormone (PTH). When calcium is low because of declining kidney function, the parathyroid glands sense it right away and respond by making more PTH.

Frequently asked questions about SHPT

What is SHPT? Expand

Secondary hyperparathyroidism (SHPT) is a condition in which the parathyroid glands produce too much hormone (PTH). SHPT is common in people in Stages 3, 4, and 5 of CKD.

What are the parathyroid glands? Expand

The parathyroid glands are four pea-sized glands. They are located in the neck, behind the thyroid gland.

What do the parathyroid glands do? Expand

The parathyroid glands produce parathyroid hormone, or PTH. PTH is important because it helps to control the amount of calcium and phosphorus in the body.

Why do people with chronic kidney disease (CKD) get SHPT? Expand

In CKD, kidney function decreases. The kidneys can’t do their jobs effectively.

  • Vitamin D cannot be activated—When kidney function decreases, the body has trouble turning vitamin D (from diet and other sources) into the “active” form of vitamin D (calcitriol) that the body can use
  • Parathyroid glands become overactive (secondary hyperparathyroidism)—When calcium and/or active vitamin D levels get too low, the parathyroid glands put out more PTH
  • Calcium and phosphorus become out of balance—CKD and SHPT can cause calcium and phosphorus levels in your body to become out of balance

Now that you know more about SHPT (secondary hyperparathyroidism), it is important to take action:

  1. TALK—If you are one of the more than 16 million patients with chronic kidney disease (CKD) in Stages 3, 4, or 5, make sure you talk to your doctor about SHPT (secondary hyperparathyroidism).3,4
  2. TEST—Simple blood tests can help you and your doctor keep a check on your PTH levels. Talk to your doctor about getting a PTH test.
  3. TREAT—If you have SHPT, your doctor can discuss with you why treating SHPT is important.

During treatment for SHPT, your doctor should test your blood and adjust your medication dose based on the test results.

Next: Why Treating SHPT Is Important









Use and Important Safety Information

Use1

ZEMPLAR® (paricalcitol) Capsules are an active form of vitamin D used to prevent and treat secondary hyperparathyroidism (increased parathyroid hormone levels) in patients with Stage 3 or Stage 4 chronic kidney disease and in Stage 5 patients on dialysis.

Important Safety Information1

You should not start or continue to take ZEMPLAR Capsules if you have symptoms of high calcium or vitamin D. Taking too much vitamin D or taking it for a long time can cause very high calcium or vitamin D levels which may cause serious health problems and the need for emergency medical care. Signs of high calcium include feeling tired, difficulty thinking clearly, loss of appetite, nausea, vomiting, constipation, increased thirst, increased urination, and weight loss. Tell your doctor if you are having any of these signs.

Before and while taking ZEMPLAR Capsules, tell your doctor about all medications that you are taking, including prescription and nonprescription drugs, aluminum-containing compounds, supplements, and herbal preparations, or any change in your medical condition.

Your doctor should measure your blood levels of PTH, calcium, and phosphorus before starting you on and while you are taking ZEMPLAR Capsules. Your doctor may order the tests more often when you begin ZEMPLAR Capsules or if your dose is changed. Your doctor may adjust your dose based on the results of your blood tests.

It is important that you follow your ZEMPLAR medication plan exactly as your doctor has ordered and follow any instructions you were given about your diet and phosphorus restrictions.

The most common side effects with the use of ZEMPLAR Capsules include diarrhea, nausea, swelling, allergic reaction, viral infection, high blood pressure, vomiting, inflammation of the throat and nose and dizziness.

This is the most important information to know about ZEMPLAR Capsules. For more information, talk with your health care provider.

Reference:

  1. Zemplar® (paricalcitol) Capsules [package insert]. North Chicago, IL; Abbott Laboratories.