Hypercalcemia & Parathyroid Hormone - Kidney Disease

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Hypercalcemia & Parathyroid Hormone

lowraind profile image
9 Replies

At my last visit to the Nephrologist, my Calcium count was high. Nothing had changed in my normal pattern. I did some research (I usually go to Mayo Clinic and Cleveland Clinic sites) and discovered that this could be due to an overactive parathyroid gland. Neph. took additional blood and 1st results came in today with Calcium back in normal range, but the Parathyroid Hormone was high. Anyone have experience with this and what was done?

Thanks

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lowraind
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rabbit01 profile image
rabbit01

Hi. Yes I have an overactive Parathyroid gland. However I don't blame my Parathyroid glands themselves as from what the nephrologist tells me the over production of the Parathyroid Hormone (PTH) is due to my failed kidneys. Apparently healthy kidneys monitor the calcium in our blood and send a signal to the Parathyroid glands that everything is ok. However once our kidneys start to fail then they no longer send the signal and so the Parathyroid glands think that we have a shortage of calcium and produce PTH to reclaim some of that missing calcium from our bones. This of course leads to an over supply of calcium in our blood and also a reduction of calcium in our bones which can lead to renal osteodystrophy which is a thinning and weakening of our bones. My nephrologist prescribed me with a tablet called Alfacalcidol which I believe helps absorb some of the excess PTH. I have also heard that one or more of the Parathyroid glands can be removed in extreme cases.

lowraind profile image
lowraind in reply torabbit01

Thanks. What I find interesting is that on the first test, my Calcium level was 11.6 (reference range being 8.4-10.2). This prompted the 2nd series of blood tests. On the results I received this morning, Calcium level was down to 9.8, within reference range, but Parathyroid Hormone was 130.2 (ref. range 8.0-77.0). I did read that three of the four glands could be removed by way of outpatient surgery. I expect I will get a call today about this, or she might wait until all results are in. For the time being, I am off Calcium and D3.

lowraind profile image
lowraind in reply tolowraind

Also, 1st test eGFR was 39, 2nd it was 47. This was about a week apart.

KidneyCoach profile image
KidneyCoachNKF Ambassador in reply tolowraind

The imbalance of calcium and phosphorus is what triggers the high PTH. Many (including myself) have completely normal calcium and phosphorus levels yet the PTH levels go into hyperdrive. Dialysis patients' levels are considered "okay" if below 300. My doctor refused to adequately treat my high PTH for 6 years. At one point my PTH levels were over 3500 - yes 3 thousand 5 hundred. I had 3 1/2 parathyroids removed and it changed my life for the better. Sadly the damage to my bones was done and could not be recovered. I have multiple compression fractures in spine, broken finger, toes, leg and arm. Calcitriol or a form of it can be very beneficial. For someone without CKD the level of PTH should be under 100-150. My PT surgery was inpatient. I stayed for 5 days. The surgery was about 4 hours. I had hungry bone syndrome where my calcium dropped dangerously low and needed I.V. calcium several times daily to bring it within normal limits. Pain was minimal, recovery quick and easy. Blessings

rabbit01 profile image
rabbit01 in reply toKidneyCoach

My goodness why on earth didn't they treat it with medication before it caused all that damage?

KidneyCoach profile image
KidneyCoachNKF Ambassador in reply torabbit01

Control

rabbit01 profile image
rabbit01 in reply toKidneyCoach

Wow! My goodness. My first nephrologist was hopeless and kept saying let's leave it four weeks and see what happens. Never prescribed a thing. I am so annoyed that I trusted them.

PecanSandie profile image
PecanSandie

You should ask for a Dexascan to find out if you have osteopenia or osteoporosis. I have the exact same issues - my parathyroid level is high - but my nephrologist prescribed Calcitriol (synthetic vitamin d) to help bring it down. I haven't been taking it for too long but at the last test, my PTH was somewhat lower.

lowraind profile image
lowraind

I have been taken off both Calcium and Vitamin D. --First test result had Calcium at 11.6, with a reference range of 8.4 - 10.2. At that

time I was told to stop taking Calcium and Vitamin D. Second test result had

Calcium at 9.8.

--Had no result for Vitamin D on first test. Second test showed Vitamin D at 79.9 with

a reference range of 30.0 - 100.0. When I received a call from the nephrologist's

office, I was told that the Dr. was concerned about the high level of Vitamin D.

I asked was the Vit. D was a concern and not the Parathyroid Hormone which was 130.2 with a reference range of 8.0 - 77.0. The response was that this is a part of CKD, and we would not be looking at surgery. I then was sent paperwork for a blood test before my next six month appointment, and this time they will be testing for:

--Vitamin D 25

--Magnesium

--PTH Intact (Parathyroid Hormone, I guess)

--Basic Metabolic Panel

--Albumin

--Phosphorus

Under Diagnoses they have listed:

--Hypercalcemia

--CKD, Stage 3B (even though my level at the 2nd test was 47)

--Systemic Lupus Erythematosus (I have been diagnosed) and,

--Prerenal Azotemia, which was not mentioned anywhere previously. Guess this will be my next line of questioning on this site.

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