Primary prevention

Management of hypertension can help avoid chronic kidney disease (CKD) and the secondary hyperparathyroidism (SHPT) that frequently result. Likewise, diabetes mellitus requires aggressive, optimal management to reduce complications. Weight management and improved nutrition could help prevent the huge burden of type 2 diabetes mellitus and the resulting kidney damage and SHPT.

Prevention of hyperparathyroidism in CKD requires aggressive phosphorus management early in the disease course and adequate replacement of the active form of vitamin D (1,25-dihydroxyvitamin D).[1]​ Calcium levels can be managed in the dialysis fluid of the patients requiring dialysis. Low-phosphorus diets and the use of phosphorus-binding drugs that prevent enteral absorption can help limit hyperphosphatemia. Phosphorus binders containing aluminum are avoided as they can be toxic to the skeleton.[11][25]​​[29][30]

To prevent vitamin D deficiency, it is recommended that individuals are exposed to direct sunlight on their arms or legs at least twice a week.[31] However, season, geographic latitude, time of day during sun exposure, degree of skin pigmentation, cloud cover, and smog are all factors that dictate how much vitamin D is produced, such that there is no consensus on what constitutes safe and effective exposure to sunlight.[3][12][15] A combination of sensible sun exposure along with adequate vitamin D supplementation for all children and adults is suggested to prevent vitamin D deficiency in the general population.[2][15] 

Secondary prevention

The patient should maintain adequate nutrition (including calcium) and either appropriate intake of vitamin D or adequate sunlight exposure to induce normal vitamin D levels, along with an adequate level of physical activity.

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