1st order laboratory parameters – obligatory laboratory tests.
- Small blood count
- Renal parameters – creatinine, urea, creatinine clearance.
- Phosphate [hyperphosphatemia (excess phosphate) (in renal secondary hyperparathyroidism/parathyroid hyperfunction) – common, especially when glomerular filtration rate (GFR) falls below 30%]
- Serum parathyroid hormone and calcium [in secondary hyperparathyroidism: serum parathyroid hormone ↑ and calcium ↓]
- Alkaline phosphatase in serum (or the bone-specific isoenzyme) – increased depending on the extent of bone turnover increase in secondary hyperparathyroidism.
Laboratory parameters 2nd order – depending on the results of the history, physical examination and the obligatory laboratory parameters – for differential diagnostic clarification.
- Calcitriol (vitamin D3) – decreased renal calcitriol formation (vitamin D3) [calcitriol ↓]
- Bone biopsy (due tohistology/fine tissue examination).
