About Secondary Hyperparathyroidism
SHPT is an early and major complication of CKD and progresses as GFR declines1
A study evaluating calcitriol and PTH values in 150 patients with various levels of chronic renal insufficiency.
- Parathyroid hormone levels begin to rise by CKD stage 3
(GFR <60 mL/min/1.73 m2)2 - Decreases in active vitamin D occur even before PTH begins to rise2
- Patients may have already lost up to 50% of their active vitamin D levels as early as CKD stage 32
Calcium and phosphorus levels may appear normal even as PTH rises3
Prevalence data based on results of patients (N=446) enrolled in a multicenter, longitudinal cohort study of patients with chronic kidney disease. This graph was adapted from K/DOQI clinical practice guidelines for chronic kidney disease: evaluation, stratification, and classification.
- Calcium and phosphorus levels may appear normal at earlier stages of CKD3,4
- By CKD stage 5, mineral alterations (decreased calcium and increased phosphorus) are common4
References
- National Kidney Foundation. K/DOQI clinical practice guidelines for bone metabolism and disease in chronic kidney disease. Am J Kidney Dis.2003;42(suppl 3):S1-S202.
- Llach F, Yudd M. Pathogenic, clinical, and therapeutic aspects of secondary hyperparathyroidism in chronic renal failure. Am J Kidney Dis.1998;32(suppl 2):S3-S12.
- Martinez I, Saracho R, Montenegro J, Llach F. The importance of dietary calcium and phosphorus in the secondary hyperparathyroidism of patients with early renal failure. Am J Kidney Dis.1997;29:496-502.
- National Kidney Foundation. K/DOQI clinical practice guidelines for chronic kidney disease: evaluation, classification, and stratification. Am J Kidney Dis.2002;39(suppl 1):S1-S266.
