What would be a good treatment for secondary hyperparathyroidism?

Vit D analogue: Not regular vitamin d. You need calcitiriol, zemplar, or Hectorol which are already partially activated and don't require the kidney's final hydroxylation step to make them work.

Hyperparathyroid Tx: There are 2 major ways to treat second hyperparathyroidism (shpt). One is with vit d analouges, zemplar or hectorol. The problem with them is that they also increase levels of calcium (c) and phosphorous (p). If these are high, you can use sensipar (s) which will lower PTH levels with no increase in c or p levels. If your PTH level is > 500, you will probably need s to lower it effectively.

Treat the cause: Secondary hyperparathyroidism is seen in Chronic Kidney Failure.If you treat the kidney failure the hyperparathyroidism will improve Other causes are Chronic Pancreatitis,Small Bowel Disease and post Bariatric Surgery Treat the cause low calcium with Calcium and Vitamin D Supplement