Seek expert advice.
The intermittent administration of i.v. 1,25 (OH)2 D may postpone the evolution of secondary hyperparathyroidism to tertiary hyperparathyroidism.
The treatment of choice is subtotal parathyroidectomy leaving about 100 mg of parathyroid tissue. The tissue may be implanted into the arm or another accessible site to facilitate future surgery if required. Invasive tumour like overgrowth of the implants may occur.
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