Tertiary hyperparathyroidism often occurs in patients who have had a kidney transplant or require dialysis for their kidney disease. In these cases, the parathyroid glands do not respond appropriately to the normal or high levels of calcium in the blood. This results in high levels of parathyroid hormone, which can cause kidney stones, osteoporosis and poor kidney function. Often, all of the parathyroid glands are over-secreting. This can be treated with surgery that removes three or 3 1/2 of the parathyroid glands.