• Nages Nagaratnam
  • Kujan Nagaratnam
  • Gary Cheuk
Reference work entry


Tertiary hyperparathyroidism occurs in patients with chronic renal failure, increases with age and is higher in postmenopausal women. The incidental finding of asymptomatic PHPT in the older patient poses problems, and there is little guidance on how to manage them. In hyperparathyroidism, the plasma calcium level is rarely >3.00 mmol/L, but the ionised calcium is almost always elevated and is a more sensitive test. In secondary hyperparathyroidism (SHPT), the abnormality in the parathyroid glands is induced by a sustained hypocalcaemic stimulus and usually associated with parathyroid hyperplasia. Tertiary hyperparathyroidism occurs in patients with chronic renal failure. The chapter reviews hyperparathyroidism and the management.


Primary hyperparathyroidism Secondary hyperparathyroidism Tertiary hyperparathyroidism Parathyroid hormone 


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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Nages Nagaratnam
    • 1
  • Kujan Nagaratnam
    • 1
  • Gary Cheuk
    • 2
  1. 1.The University of SydneyWestmead Clinical SchoolWestmeadAustralia
  2. 2.Rehabilitation and Aged Care ServiceBlacktown-Mt Druitt HospitalMount DruittAustralia

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