Renal hyperparathyroidism (rHPT) is an adaptive response of human body based on the disorder of calcium and phosphorus metabolism in chronic kidney disease (CKD) and the progressive aggravation of vitamin D hypofunction

characterized by hyperparathyroidism and excessive synthesis and secretion of parathyroid hormone (PTH). It occurs in the early stage of renal failure and is associated with increased risk of fracture

cardiovascular disease and death. The vitamin D supplementation and reduction of phosphorus intake can be used in the early stage of CKD

while calcium mimetic agent can be used in the end-stage of CKD. For the refractory secondary hyperparathyroidism (SHPT) with poor drug treatment

parathyroidectomy can be performed. Renal transplantation can improve rHPT

but can’t cure that. In this review

we summarized the pathophysiology

diagnosis and drug treatment of rHPT

elaborated the effect of renal transplantation

and discussed the indication and strategy on SHPT.