PTH: What Is It and How Can I Control It?
PTH is an abbreviation for parathyroid hormone, which is made in the parathyroid
glands. These four tiny glands are located next to the thyroid gland at the front of your
neck.
PTH is a hormone that can affect many organs and tissues in your body. It is important to
maintain the correct level of PTH in your body. However, what is considered normal may
vary, depending on the type of test used to determine PTH. The lab test to determine this
level is called intact PTH. If you do not know your PTH level, ask your nephrologist.
Healthy kidneys will keep the right balance of calcium, phosphorus, and PTH. But when
the kidneys fail, your parathyroid glands may produce too much PTH. This is called
secondary hyperparathyroidism or high PTH. This problem can start before you need
dialysis.
High-PTH levels may cause:
 Itching
 Bone pain
 Blocked blood vessels
 Weak or broken bones
 Heart attacks
Oral and intravenous medications can help control PTH. Some examples of oral
medications are calcitriol, doxercalciferol, and cinacalcet. Some of the intravenous
medications are IV calcitriol, paricalcitol, and doxercalciferol. These medications are
helpful in maintaining strong bones and a healthy heart, nerves, muscles, and red blood
cells.
In order to receive these medications, you must keep the level of phosphorus in your
blood at a safe level—3.5 to 5.5 milligrams/deciliter. To keep the phosphorus level in this
range, you must follow a diet restricted in phosphorus. Most foods have some
phosphorus, but some foods are especially high in phosphorus.
Avoid the following foods that are high in phosphorus:
 Beans (red, black, white)
 Liver
 Milk (any kind)
 Milk products, such as:
– Yogurt
– Chocolate
– Ice cream
– Cheese
– Pudding
 Nuts
 Sardines
The doctor usually prescribes a medication called a phosphate binder to help control the
phosphorus in your blood. Some of these phosphate binders are Tums®, calcium acetate,
sevelamer, and lanthanum carbonate. Remember, the control or balance of phosphorus in
the blood is not a problem if you have healthy kidneys. Some phosphorus, but very little,
is removed during dialysis. For most people on dialysis, this is the most difficult thing to
control.
Do your part to keep your PTH level in the safe range by:
 Following your diet
 Taking your phosphate binders
 Staying for your complete dialysis treatment
References and recommended readings
MedlinePlus. PTH. Available at:
http://www.nlm.nih.gov/medlineplus/ency/article/003690.htm. Accessed January 7, 2013.
National Kidney Foundation™. Managing PTH in CKD-MBD: Insights for Dialysis.
Available at: http://www.kidney.org/professionals/tools/pdf/12-100202_LBA_PTH_CKD-MBD_Tool_feb4.pdf. Accessed January 7, 2013.
Review Date 1/13
R-0543