What is secondary hyperparathyroid?

Secondary to a chronic stimulus, typically chronic renal failure, another cause if vitamin D deficiency. In CKD response to hyperphosphatemia, hypocalcemia, impaired vitamin D production, particularely hyperPh most important as it directly stimulates PTH synthesis and causes hyperplasia promoting secondary hyperPT Seen in pt w/CKD undergoing dialysis (they get bone disease and non skeletal issues like valvular calcification, soft tissue calcification, compromised immune system, neurobehavioral changes and altered erythropoiesis In pt w/vitamin D deficiency manifestations of vitamin D deficiency appear, some have bone pain