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Hyperparathyroidism, desired phosphate and low or normal calcium

doc_thinkingAssessing the Clinical and Laboratory Parameters 

The parathyroid glands are overactive in the face of a normal phosphate and a normal or low calcium level.

Depending on the level of the calcium, the PT gland may be responding to relative hypocalcemia.  If the calcium level is at the upper end of the normal range the PT gland may be relatively resistant to the calcium signal

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

Therapeutic Options:

Dialysis Prescription

Dialysis Prescription

No change in the dialysis prescription is suggested unless 1.00 mmol/L dialysate is being used.  This may be causing frequent episodes of hypocalcemia during dialysis and keeping the PTH level high.  A dialysate calcium concentration of 1.25 mmol/L is recommended.

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