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Secondary Hyperparathyroidism — RACP Paediatrics MCQ

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ModerateEndocrinologySecondary HyperparathyroidismRACP Paediatrics

A 6-year-old child with chronic kidney disease has a serum phosphate of 2.8 mmol/L (elevated) and calcium of 2.0 mmol/L (low). PTH is markedly elevated. What is this condition called?

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Correct answer: E — Secondary hyperparathyroidism (renal osteodystrophy)

CKD leads to secondary hyperparathyroidism: reduced renal phosphate excretion (hyperphosphataemia), impaired vitamin D activation (low 1,25-dihydroxyvitamin D), and hypocalcaemia, all stimulating PTH secretion. Management includes phosphate binders, active vitamin D (calcitriol), and dietary phosphate restriction.

Reference: RCH Melbourne – 2024 – Clinical Practice Guidelines: CKD Bone Disease