Learn what secondary hyperparathyroidism (SHPT) is, how it develops and why early treatment is essential
Inside your neck, there are four pea-sized glands known as parathyroid glands. The glands are located on the back of your thyroid gland, with two on the right side and two on the left side.1
The glands release a hormone called parathyroid hormone (PTH), which helps to control your calcium, vitamin D hormone and phosphate levels.1,2
Secondary hyperparathyroidism is a condition in which the parathyroid glands are forced to release too much parathyroid hormone as a result of another disorder.1,2 The most common disorder that causes secondary hyperparathyroidism is chronic kidney disease (CKD).1
Your kidneys have many important jobs that help to keep your body healthy.3 These include helping to control the amounts of calcium, phosphate and vitamin D hormone in your blood.2,4
When you have chronic kidney disease, your kidneys gradually become unable to maintain the right balance of these blood parameters. In order to bring them back into balance, your parathyroid glands release parathyroid hormone.2,4
The parathyroid hormone works at first, but as your chronic kidney disease gets worse, your parathyroid glands are forced to release abnormally large amounts of parathyroid hormone. This is known as secondary hyperparathyroidism, or SHPT.2,4
SHPT can develop as early as stage 2 chronic kidney disease (kidney function 60–89% of normal).5
It affects up to:5
of patients with stage 3 chronic kidney disease (kidney function 30–59% of normal)
of patients with stage 4 chronic kidney disease (kidney function 15–29% of normal)
In early stages of secondary hyperparathyroidism, you may not have any symptoms.6
As secondary hyperparathyroidism progresses, you may experience tiredness, muscle soreness and aching in your bones and joints. These symptoms may gradually increase in severity.6
If you experience these or any other symptoms, please tell your nephrologist or nurse.
Without early and effective treatment, SHPT may increase your risks of bone and heart disease.7,8 Some research even links SHPT with more rapid progression of chronic kidney disease.8,9
However, if secondary hyperparathyroidism is diagnosed early, effective management is possible.10,11
- Ilahi A et al. StatPearls [Internet]. Treasure Island (FL):
StatPearls Publishing; 2020 Jan–. Available from: https://
www.ncbi.nlm.nih.gov/books/NBK537203/ [updated 2020
August 10; accessed 2021 February 26]. - Cunningham J et al. Clin J Am Soc Nephrol. 2011;6:913–21.
- Traynor J et al. BMJ. 2006;333(7571):733–7.
- Rodriguez M et al. Am J Renal Physiol. 2005;288:F253–64.
- Levin A et al. Kidney Int. 2007;71:31–8.
- Levy AR et al. Am J Kidney Dis. 2020;75(3):373–83.
- Geng G et al. Osteoporos Int. 2019;30:2019–25.
- Xu Y et al. Clin Kidney J. 2021;sfab006.
- Schumock G et al. Curr Med Res Opin. 2008;24:3037–48.
- Tomasello S. Diabetes Spectr. 2008;21:19–25.
- Locatelli F et al. Nephrol Dial Transplant. 2002;17:723–31.