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Secondary Hyperparathyroidism

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The disorder known as secondary hyperparathyroidism (SHPT) occurs when the parathyroid glands overproduce parathyroid hormone (PTH) in reaction to low blood calcium levels.Secondary hyperparathyroidism results from an underlying illness, most frequently chronic kidney disease (CKD), in contrast to primary hyperparathyroidism, which is typically brought on by a problem with the parathyroid glands themselves. The kidneys' inability to control blood levels of calcium and phosphorus in CKD results in abnormalities. The conversion of vitamin D to its active form, calcitriol, which is necessary for the absorption of calcium from the intestines, is impossible when the kidneys are not operating properly. As a result, there is insufficient calcium in the blood, or hypocalcemia.The parathyroid glands overreact in response, releasing too much parathyroid hormone in an attempt to raise calcium levels. The consequences of secondary hyperparathyroidism may be harmful to general health as well as bone health. Overprolific PTH encourages the bloodstream's release of calcium and phosphorus from the bones, which can gradually weaken the bones and cause renal osteodystrophy. As a result, patients may have deformities, fractures, and bone discomfort. Moreover, the body may experience systemic repercussions from high PTH levels. Vascular calcification, or the buildup of calcium deposits in blood vessels, can be brought on by high PTH levels and raise the risk of cardiovascular disease. Furthermore, SHPT may be a factor in weariness, cognitive decline, and muscle weakness. The goal of treating secondary hyperparathyroidism is to address the underlying cause, such as chronic kidney disease. Since elevated phosphorus levels can exacerbate SHPT, it is essential to control phosphorus levels with food adjustments and medication. It may be necessary to administer vitamin D analogs or supplements to assist reduce the generation of PTH and enhance calcium absorption. When conservative measures fail, it may occasionally be necessary to remove the parathyroid glands surgically. For individuals with secondary hyperparathyroidism, regular monitoring of calcium, phosphorus, PTH, and bone health markers is crucial to preventing complications and managing the disease successfully. To provide patients with SHPT complete care, a multidisciplinary strategy comprising nephrologists, endocrinologists, and dietitians is frequently used.