Chapter 56 Treatment of Hypoparathyroidism with Calcium and Vitamin D

Calcium and vitamin D metabolite therapy is currently the cornerstone of therapy in hypoparathyroidism. Limitations to therapy include the development of hypercalciuria and hyperphosphatemia with an increased risk of extra-skeletal calcification, as well as impairment in renal function. Wide fluctuations in serum calcium, with this therapeutic approach, also significantly impact quality of life. Advances in therapy include the availability of benzothiadiazines, which effectively enhance renal calcium reabsorption and lower urinary calcium excretion. PTH therapy with both rhPTH(1–34) and rhPTH(1–84) constitute an important potential therapeutic advance.