[The effect of subtotal parathyroidectomy in patients on haemodialysis]

Secondary hyperparathyroidism is one of the main and most consistent clinical manifestations of chronic renal failure. It develops in the early stage of chronic renal failure, and its severity increases with further deterioration of renal function. Renal osteodystrophy is the most frequent form of secondary hyperparathyroidism. The management of secondary hyperparathyroidism leads to improvement of calcium and phosphorus homeostasis and suppression of parathyroid secretion. Such treatment with medicament may be unsuccessful, and certain features of secondary hyperparathyroidism may necessitate parathyroid surgery. The aim of this article is to present our experience in the treatment of secondary hyperparathyroidism with subtotal parathyroidectomy. Twenty two patients on haemodialysis after subtotal parathyroidectomy were followed for about 2 years (x +/- SD: 2.0 +/- 1.5) after the operation. During this time the effect of operation on biochemical and clinical signs, and radiographical features of secondary hyperparathyroidism was evaluated. According to our results the subtotal parathyroidectomy stopped in most cases, the progression of secondary hyperparathyroidism. In two patients the reappearance of overt secondary hyperparathyroidism was observed 2.5 and 3.5 years after the operation.