Overview of SHPT

Learn what secondary hyperparathyroidism (SHPT) is, how it develops and why early treatment is essential

What is secondary hyperparathyroidism?
Icon showing parathyroid glands

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

Side view of neck showing thyroid gland and two parathyroid glands

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

Side view of neck showing thyroid gland and two parathyroid glands
Excessive parathyroid hormone being released by the parathyroid glands due to kidney failure
How does secondary hyperparathyroidism develop in chronic kidney disease?
Icon showing an arrow that points both up and down

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

Excessive parathyroid hormone being released by the parathyroid glands due to kidney failure

About the jobs of kidneys

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

How CKD causes SHPT

How common is secondary hyperparathyroidism in chronic kidney disease?
Kidney icon

SHPT can develop as early as stage 2 chronic kidney disease (kidney function 60–89% of normal).5

Female secondary hyperparathyroidism patient writing

It affects up to:5

40%

of patients with stage 3 chronic kidney disease (kidney function 30–59% of normal)

82%

of patients with stage 4 chronic kidney disease (kidney function 15–29% of normal)

Female secondary hyperparathyroidism patient writing
Male secondary hyperparathyroidism patient watering plants with watering can
What are the symptoms of secondary hyperparathyroidism?

In early stages of secondary hyperparathyroidism, you may not have any symptoms.6

Male secondary hyperparathyroidism patient watering plants with watering can
Bone icon

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

Stethoscope icon

If you experience these or any other symptoms, please tell your nephrologist or nurse.

Why is early management of secondary hyperparathyroidism essential?
Heart icon

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

Female secondary hyperparathyroidism patient making tea

About the risks of SHPT

However, if secondary hyperparathyroidism is diagnosed early, effective management is possible.10,11

About SHPT management

Female secondary hyperparathyroidism patient making tea
References
  1. 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].
  2. Cunningham J et al. Clin J Am Soc Nephrol. 2011;6:913–21.
  3. Traynor J et al. BMJ. 2006;333(7571):733–7.
  4. Rodriguez M et al. Am J Renal Physiol. 2005;288:F253–64.
  5. Levin A et al. Kidney Int. 2007;71:31–8.
  6. Levy AR et al. Am J Kidney Dis. 2020;75(3):373–83.
  7. Geng G et al. Osteoporos Int. 2019;30:2019–25.
  8. Xu Y et al. Clin Kidney J. 2021;sfab006.
  9. Schumock G et al. Curr Med Res Opin. 2008;24:3037–48.
  10. Tomasello S. Diabetes Spectr. 2008;21:19–25.
  11. Locatelli F et al. Nephrol Dial Transplant. 2002;17:723–31.