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Hyperparathyroidism, hypophosphatemia & low or normal calcium


Assessing the Clinical and Laboratory Parameters


This is an unusual combination, with several possibilities;

  1. True vitamin D deficiency (i.e. measure serum 25 OH D).
  2. Diet and phosphate binder dosing are associated with malnutrition.
  3. Consider direct suppression of PT glands with either active vitamin D analogues or calcimimetics (expensive)

Less than 1% of all patients are in this category.


Dialysis Prescription

Dialysis Prescription

If technically simple, consider increasing dialysate calcium by 0.25 – 0.50 mmol/L (0.50-1.00 mEq/L).




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