skip to main content

Tertiary Hyperparathyroidism — RACP Paediatrics MCQ

Instant feedback + full explanation. One question, done properly.

HardNephrologyTertiary HyperparathyroidismRACP Paediatrics

A 14-year-old with ESRD on haemodialysis has secondary hyperparathyroidism with PTH 8 times the upper limit of normal despite phosphate binders and calcitriol. What complication may develop?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: B — Tertiary hyperparathyroidism (autonomous PTH secretion)

Prolonged stimulation of parathyroid glands in CKD can lead to autonomous PTH secretion (tertiary hyperparathyroidism), where PTH remains elevated even when calcium/phosphate/vitamin D are corrected. Calcimimetics (cinacalcet) or parathyroidectomy may be needed.

Reference: RCH Melbourne – 2024 – Clinical Practice Guidelines: CKD-MBD