Low serum Ca stimulates PTH production and secretion
Usually associated with low vitamin D or CKD as they cant respond to the PTH, and thus cant activate vitamin D to increase absorption of Ca from gut or kidney (also cant increase phosphate excretion
Only place Ca can come from is bone = renal bone mineral disease
PTH enlarges and produces unregulated amounts of PTH = hyperplasia over time
Findings -
This is treated by correcting the vitamin D deficiency or performing a renal transplant to treat renal failure.
Secondary hyperparathyroidism causing hyperplasia of the glands = An increase in the baseline levels of PTH
Then when the cause of the secondary hyperparathyroidism is treated the parathyroid hormone level remains inappropriately high. This high level of parathyroid hormone in the absence of the previous pathology leads to high absorption of calcium in the intestines, kidneys and bones and causes hypercalcaemia. This is treated by surgically removing part of the parathyroid tissue to return the parathyroid hormone to an appropriate level.
Findings: