Patient Scenario: Desired PTH, hyperphosphatemia and hypercalcemia

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Assessing the Clinical and Laboratory Parameters

Phosphate control is suboptimal in this patient. Assess dietary intake, binders and timing of binders with meals.  

Assess use of vitamin D and Calcimimetics. The PTH level is at the target range, which may be due to the current use of vitamin D sterols in an effort to control hyperparathyroidism.  The vitamin D sterol may be increasing both the calcium and the phosphate absorption.  It is likely that the hypercalcemia is also contributing to the current PTH level.

It is unusual to see hyperphosphatemia and hypercalcemia in a patient receiving calcimimetics

Approximately 4% of all patients are in this category.


Therapeutic Options:


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