"Increase in PTH secretion in response to hypocalcemia :
As in chronic renal failure (Renal Osteodystrophy)
PTH elevated due to decreased levels of calcium or 1
25-dihydroxy-vitamin D3.
Failing kidneys do not convert enough vitamin D to its active form
Most patients with hyperparathyroidism secondary to chronic kidney disease
will improve after renal transplantation
but many will continue to have a degree of
residual hyperparathyroidism (tertiary hyperparathyroidism) post-transplant
with associated risk of bone loss
etc.
Prognosis
If left untreated
the disease will progress to tertiary hyperparathyroidism
where correction of the underlying cause will not stop excess PTH secretion
i.e. parathyroid gland hypertrophy becomes irreversible.
TREATMENT:
Medical
1) Treat underlying cause ie. renal transplant
2) Dietary restriction of phosphorus.
(Phosphate is not excreted in CRF
which alters calcium levels)
3)Vitamin D supplements
4)Cinacalcet
Surgical:
Parathyroidectomy"