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Management of Primary and Secondary Hyperparathyroidism in a Patient With Chronic Kidney Disease (CKD)
Bashirat O Johnson1, Sunggeun Lee2
1Internal Medicine, New York Medical College, Metropolitan Hospital Center, New York City, USA.
Abstract:
An 82-year-old female with stage 4 chronic kidney disease (CKD) presented with asymptomatic hypercalcemia and elevated parathyroid hormone (PTH) levels. Workup confirmed primary hyperparathyroidism due to a parathyroid adenoma, with secondary hyperparathyroidism due to CKD. Given her age and surgical risk, she was managed medically with cinacalcet, later switched to calcitriol due to hypocalcemia, then reverted to cinacalcet after recurrent hypercalcemia. This case illustrates the diagnostic and therapeutic challenges of managing coexisting primary and secondary hyperparathyroidism in CKD, highlighting the importance of individualized, guideline-based medical therapy and close biochemical monitoring.
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