Which of the following lists reflects the plasma/serum changes seen in suspected secondary hyperparathyroidism?

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Multiple Choice

Which of the following lists reflects the plasma/serum changes seen in suspected secondary hyperparathyroidism?

In suspected secondary hyperparathyroidism (often due to chronic kidney disease), the kidneys’ inability to excrete phosphate leads to phosphate retention. The elevated phosphate binds calcium, lowering free calcium levels in the blood. That fall in calcium stimulates the parathyroid glands to secrete more parathyroid hormone. The excess PTH then increases bone turnover, which raises alkaline phosphatase. So the typical lab pattern is high PTH, high alkaline phosphatase, low or normal calcium, and high phosphate. This contrasts with primary hyperparathyroidism, where calcium is usually high and phosphate is low.

In suspected secondary hyperparathyroidism (often due to chronic kidney disease), the kidneys’ inability to excrete phosphate leads to phosphate retention. The elevated phosphate binds calcium, lowering free calcium levels in the blood. That fall in calcium stimulates the parathyroid glands to secrete more parathyroid hormone. The excess PTH then increases bone turnover, which raises alkaline phosphatase. So the typical lab pattern is high PTH, high alkaline phosphatase, low or normal calcium, and high phosphate. This contrasts with primary hyperparathyroidism, where calcium is usually high and phosphate is low.

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