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The major target end organs for parathyroid hormone (PTH) action are the kidneys, skeletal system, and intestine. The primary response to parathyroid hormone (PTH) by the kidney is to increase renal calcium resorption and phosphate excretion.
Therefore, people with a normal blood calcium levels and a high PTH level may have secondary hyperparathyroidism(see Special Cases: Secondary Hyperparathyroidism), which means that the high PTH level is a normal response of healthy parathyroids glands to another problem (like vitamin D deficiency or kidney failure).