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Tertiary hyperparathyroidism is a condition characterized by excessive production of parathyroid hormone (PTH) by the parathyroid glands, leading to increased calcium levels in the blood. It typically occurs in patients with long-standing secondary hyperparathyroidism, often as a result of chronic kidney disease (CKD). The primary treatment goal for tertiary hyperparathyroidism is to normalize PTH levels and maintain calcium and phosphorus balance. This typically involves the use of medications to control hypercalcemia and hyperphosphatemia. Calcimimetic agents, such as cinacalcet, can help lower PTH levels by increasing the sensitivity of the calcium-sensing receptors on the parathyroid glands. Additionally, phosphate binders can be prescribed to reduce serum phosphate levels.
Tajdini et al. (Sat,) studied this question.