Role of Sonography in Hyperparathyroidism in Chronic Kidney Disease and Post-Renal Transplant Recipients

Abstract

Parathyroid hormone (PTH) is secreted by the parathyroid glands and plays a vital role in calcium metabolism by its actions on the bones, kidneys and intestines. Primary hyperparathyroidism results due to the growth of parathyroid glands themselves, leading to the increased secretion of PTH. Secondary hyperparathyroidism occurs when a stimulus outside of the parathyroid glands causes the parathyroid gland to become enlarged and overactive, resulting in an elevated serum parathyroid hormone. The stimulus is most commonly low serum calcium levels. Hence, in secondary hyperparathyroidism, the serum calcium levels are normal, and serum PTH levels are elevated appropriately in response to the stimulus. Long-standing cases of secondary hyperparathyroidism can lead to autonomous hypersecretion parathyroid hormone leading to hypercalcaemia and tertiary hyperparathyroidism. Tertiary hyperparathyroidism is usually seen in post-renal transplant recipients; however, it can also be seen in pre-transplant patients.