Effectiveness of surgical parathyroidectomy for secondary hyperparathyroidism in renal dialysis patients in Qatar

Transplantation Proceedings
A RashedM Asim

Abstract

Pharmacologic interventions designed to control hyperparathyroidism (HPT) in uremic patients have limitations and potentially serious adverse clinical consequences. Hence, one still has to resort to surgical parathyroidectomy (PTX) in a considerable number of dialysis patients. The aim of the present study was to illustrate our experience with 26 renal dialysis patients who underwent surgical PTX. The main indications for PTX included iPTH > 1000 pg/mL associated with severe osteitis fibrosa, debilitating pruritus, marked soft tissue calcification, or hypercalcemia with hyperphosphatemia, which sometimes complicated vitamin D therapy. All patients were resistant to more conservative measures, including control of serum phosphate, attention to oral intake and dialysate calcium levels, and oral/intravenous administration of active vitamin-D-pulse therapy. Ultrasound and technetium 99-sestamibi scan were used to image the thyroid and the parathyroid glands. Total PTX with autotransplantation was performed in 23 patients; subtotal PTX was performed in 3 patients. Histology of frozen sections taken intraoperatively showed nodular changes in 14 and diffuse hyperplasia in 12 cases. During the 2-year follow-up period significant reduct...Continue Reading

References

Jan 1, 1993·Nephron·F PizzarelliQ Maggiore

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Citations

Feb 27, 2014·Biochimica Et Biophysica Acta·Andreas E KremerRonald P J Oude Elferink
Aug 9, 2011·The Journal of International Medical Research·J NarandaB Pečovnik-Balon
Apr 1, 2008·The Indian Journal of Surgery·Miguel Echenique-ElizondoFernando Vidaur
Jan 8, 2020·Annals of Surgical Treatment and Research·Poh Guan TanAndee Dzulkarnaen Zakaria

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