{"id":39,"date":"2013-10-14T05:32:14","date_gmt":"2013-10-14T05:32:14","guid":{"rendered":"http:\/\/www.modestosurgery.com\/surgeryblog\/?p=39"},"modified":"2013-10-14T05:43:59","modified_gmt":"2013-10-14T05:43:59","slug":"secondary-hpt","status":"publish","type":"post","link":"http:\/\/www.modestosurgery.com\/surgeryblog\/secondary-hpt\/","title":{"rendered":"Secondary HPT"},"content":{"rendered":"<h3>Secondary Hyperparathyroidism<\/h3>\n<ul>\n<li>excessive PTH secreted by parathyroid glads in response to hypocalcemia.<\/li>\n<li>Seen in chronic renal failure (most common cause of secondary HPT)<\/li>\n<li>Bone and joint pain are common<\/li>\n<li>Parathyroid hypertrophy<\/li>\n<li>no role for parathyroid surgery<\/li>\n<li>Vitamin D deficiency can cause secondary HPT<\/li>\n<\/ul>\n<h3>Normal calcium level with elevated PTH<\/h3>\n<p>Normal calcium blood levels with an elevated PTH might be due to vitamin D levels. \u00a0Low vitamin D levels lead to elevated PTH levels to help maintain normal calcium blood levels.<\/p>\n<h3>Chronic Renal Failure<\/h3>\n<ul>\n<li>Failing kidneys fail to convert enough vitamin D to its active form<\/li>\n<li>Does not adequately excrete phosphate into the urine<\/li>\n<li>Insoluble calcium phosphate forms in the body which removes calcium from the circulation &#8211; thus hypocalcemia and thus increases parathyroid hormone in an attempt to increase serum calcium levels<\/li>\n<\/ul>\n<h3>Other causes besides renal failure<\/h3>\n<ul>\n<li>Malabsorption dependent bariatric surgery<\/li>\n<li>malabsorption due to chronic pancreatitis, small bowel disease<\/li>\n<\/ul>\n<h3>What is tertiary hyperparathyroidism?<\/h3>\n<p>Tertiary hyperparathyroidism occurs when the correction of the underlying cause will not stop excess PTH secretion<\/p>\n<h3>Vitamin D and Calcium?<\/h3>\n<p>The body needs vitamin D to absorb calcium from our diet.<\/p>\n<h3>What is primary hyperparathyroidism?<\/h3>\n<ul>\n<li>Increased PTH secretion and <strong><em>raised<\/em> serum calcium levels<\/strong><\/li>\n<li>85% caused by parathyroid adenoma (usually only one gland affected)<\/li>\n<li>10% caused by chief cell hyperplasia<\/li>\n<\/ul>\n<h3>What is hungry bone syndrome?<\/h3>\n<ul>\n<li>Severe Hypocalcemia seen after surgical correction of HPT<\/li>\n<li>Chronically deprived bone aggressively absorbs calcium<\/li>\n<\/ul>\n","protected":false},"excerpt":{"rendered":"<p>Secondary Hyperparathyroidism excessive PTH secreted by parathyroid glads in response to hypocalcemia. Seen in chronic renal failure (most common cause of secondary HPT) Bone and joint pain are common Parathyroid hypertrophy no role for parathyroid surgery Vitamin D deficiency can cause secondary HPT Normal calcium level with elevated PTH Normal calcium blood levels with an &hellip; <a href=\"http:\/\/www.modestosurgery.com\/surgeryblog\/secondary-hpt\/\" class=\"more-link\">Continue reading <span class=\"screen-reader-text\">Secondary HPT<\/span> <span class=\"meta-nav\">&rarr;<\/span><\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[23,53,24,25,51,52],"tags":[54,27],"class_list":["post-39","post","type-post","status-publish","format-standard","hentry","category-endocrine","category-hungry-bone-syndrome","category-hypocalcemia","category-parathyroid-hormone","category-secondary-hyperparathyroidism","category-vitamin-d-2","tag-calcium","tag-vitamin-d"],"_links":{"self":[{"href":"http:\/\/www.modestosurgery.com\/surgeryblog\/wp-json\/wp\/v2\/posts\/39","targetHints":{"allow":["GET"]}}],"collection":[{"href":"http:\/\/www.modestosurgery.com\/surgeryblog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"http:\/\/www.modestosurgery.com\/surgeryblog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"http:\/\/www.modestosurgery.com\/surgeryblog\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"http:\/\/www.modestosurgery.com\/surgeryblog\/wp-json\/wp\/v2\/comments?post=39"}],"version-history":[{"count":5,"href":"http:\/\/www.modestosurgery.com\/surgeryblog\/wp-json\/wp\/v2\/posts\/39\/revisions"}],"predecessor-version":[{"id":44,"href":"http:\/\/www.modestosurgery.com\/surgeryblog\/wp-json\/wp\/v2\/posts\/39\/revisions\/44"}],"wp:attachment":[{"href":"http:\/\/www.modestosurgery.com\/surgeryblog\/wp-json\/wp\/v2\/media?parent=39"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/www.modestosurgery.com\/surgeryblog\/wp-json\/wp\/v2\/categories?post=39"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/www.modestosurgery.com\/surgeryblog\/wp-json\/wp\/v2\/tags?post=39"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}