Aust Fam Physician. 2007 Dec;36(12):1029-33.

BACKGROUND: Ninety percent of cases of hypercalcaemia are due to primary hyperparathyroidism or hypercalcaemia of malignancy.

OBJECTIVE: This article outlines the diagnostic features of primary hyperparathyroidism and determines who would benefit from parathyroidectomy. It also aims to raise awareness of familial hyperparathyroid syndromes.

DISCUSSION: Diagnosis of primary hyperparathyroidism requires hypercalcaemia, elevated or inappropriately normal serum parathyroid hormone and a fractional urinary excretion of calcium greater than 0.02. Many patients benefit from parathyroidectomy, which has a high rate of cure.

The Journal of the American Board of Family Medicine 22 (5): 574-581 (2009)

Secondary hyperparathyroidism is a frequently encountered problem in the management of patients with chronic kidney disease (CKD). Its pathophysiology is mainly due to hyperphosphatemia and vitamin D deficiency and resistance. This condition has a high impact on the mortality and morbidity of dialysis patients. Early diagnosis of secondary hyperparathyroidism is crucial in the management of patients with CKD. The treatment remains a challenge for patients and their clinicians. It should include a combination of dietary phosphorus restriction, phosphate binders, vitamin D analogues, and calcimimetics.