Metastatic Calcification and 2' hyperparathyroidism

[MudPhud20XX]

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So FA lists 2' hyperparathyroidism as one of the causes for metastatic calcificaiton (increased serum Ca2+), but then if look at FA's endocrine chapter, 2' hyperparathyroidism is manifested as low Ca2+ in serum (hypocalcemia).

To me it makes sense that you should have low serum calcium with secondary hyperparathyroidism, so how come you can get a metastatic calcification with the secondary hyperparathyrodism as stated in FA?

 

[tasar1898]

Its the phosphate. Driving calcium to tissues is dependent on both the [P] and [Ca] , you multiply both to get the solubility product