What causes secondary hyperparathyroidism?

Updated: Dec 24, 2020
  • Author: Lawrence T Kim, MD, FACS, FACE; Chief Editor: Romesh Khardori, MD, PhD, FACP  more...
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Secondary hyperparathyroidism results from a chronic stimulus of the parathyroid gland to release parathyroid hormone. Parathyroid hormone release is increased in the setting of hypocalcemia and hyperphosphatemia and is decreased by fibroblast growth factor 23 (FGF-23).

Parathyroid hormone acts on bone to release calcium into the blood and activates 1 alpha hydroxylation in the kidney to form 1,25-dihydroxvitamin D, which in turn increases calcium absorption in the gastrointestinal tract. The rise in calcium detected by the calcium-sensing receptor on the parathyroid gland reduces the stimulus for parathyroid hormone excretion.

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