Abstract: Tertiary hyperparathyroidism (THPT) develops on the basis of long-standing secondary hyperparathyroidism (SHPT), characterized by autonomous secretion of parathyroid hormone (PTH) and elevated serum calcium level, and typically happens after kidney transplantation. THPT can lead to the risks of bone fracture and coronary artery calcification, and is an important factor affecting the recipients of renal transplantation. Surgery is the preferable treatment for THPT. However, some patients lose the optimal period of surgical treatment due to delayed diagnose of THPT. This article reviews recent advances in pathogenesis, clinical manifestations, imaging characteristics, diagnosis, and treatment of THPT in order to improve our knowledge about THPT.

Key words: Tertiary hyperparathyroidism, Parathyroid hormone, Renal transplantation, Parathyroidectomy