Renal Hyperparathyroidism (RHPT) 

A complication of kidney disease, renal hyperparathyroidism interferes with the body’s absorption of calcium. 
In order for the body to function properly, the levels of calcium, vitamin D and phosphorus must be kept in balance in the blood. Healthy kidneys normally change inactive vitamin D to active vitamin D, which the intestines need to absorb calcium from digested food and keep the calcium level in balance with the phosphorus level. Renal hyperparathyroidism occurs when the kidneys malfunction and lose their ability to transform inactive vitamin D to active vitamin D. 

How Does Kidney Disease Cause Renal Hyperparathyroidism? 

Because it can cause low vitamin D levels, kidney disease may interfere with the body’s absorption of calcium. In response to the low blood calcium levels, the parathyroid glands may attempt to compensate by growing larger and producing too much parathyroid hormone (PTH). The excess PTH then draws calcium from the bones to raise the level of calcium in the blood. If left untreated, renal hyperparathyroidism can lead to complications, such as osteoporosis and kidney stones. 

What Are the Symptoms of Renal Hyperparathyroidism? 

The warning signs of renal hyperparathyroidism can include: 

  • Bone and joint pain 
  • Recurrent fractures 
  • Frequent urination 
  • Weakness and fatigue 
  • Loss of appetite 
  • Nausea 

How Is Renal Hyperparathyroidism Diagnosed? 

To determine whether a patient with kidney disease has renal hyperparathyroidism, a physician may order one or more diagnostic tests, such as: 

  • Bloodwork to measure the levels of vitamin D, calcium and phosphorus in the blood 
  • A urinalysis to examine the composition of the urine  
  • X-rays to look for kidney stones or broken bones 
  • A bone density scan to evaluate bone strength and check for osteoporosis 
  • Ultrasound imaging to examine the size of the parathyroid glands

How Is Renal Hyperparathyroidism Treated? 

To effectively treat renal hyperparathyroidism, the underlying kidney disease must be addressed. In the case of end-stage renal failure, this may involve dialysis or a kidney transplant. Otherwise, a physician may suggest: 

  • Dietary changes to promote kidney health 
  • Vitamin D or calcium supplements to boost the body’s calcium levels 
  • Calcimimetics to control the production of PTH by the parathyroid glands 
  • Surgical removal of one or more parathyroid glands 

The outstanding nephrology team at Tampa General Hospital offers a full spectrum of treatment options for kidney disease and its complications, including renal hyperparathyroidism. Additionally, our parathyroid and thyroid surgeons are skilled and experienced in performing the latest minimally invasive procedures to treat parathyroid conditions.