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Updated: Jan 29, 2026
03:57
Generation of Hypoparathyroid Rats via Carbon-Nanoparticle-Assisted Parathyroidectomy
Published on: July 14, 2023
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Parathyroidectomy versus cinacalcet for tertiary hyperparathyroidism; a retrospective analysis.
R R Dulfer1, E Y Koh2, W Y van der Plas3
1Department of Surgery, Erasmus MC, University Medical Center Rotterdam, 's-Gravendijkwal 230, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands. roderickdulfer@gmail.com.
Langenbeck'S Archives of Surgery
|February 8, 2019
Summary
Parathyroidectomy (PTx) effectively normalizes both calcium and parathyroid hormone (PTH) levels in kidney transplant recipients with tertiary hyperparathyroidism (tHPT). Cinacalcet normalizes calcium but not PTH, suggesting PTx is the preferred treatment.
Area of Science:
- Nephrology
- Endocrinology
- Transplantation Medicine
Background:
- Tertiary hyperparathyroidism (tHPT) affects 17-50% of kidney transplant recipients.
- Elevated PTH post-transplant increases risk of graft dysfunction and osteoporosis.
- Optimal management of tHPT remains debated despite cinacalcet availability.
Purpose of the Study:
- To compare the efficacy of cinacalcet and parathyroidectomy (PTx) in managing tHPT after kidney transplantation.
- To evaluate the impact of both treatments on serum calcium and PTH levels.
Main Methods:
- Retrospective analysis of 94 kidney transplant recipients with tHPT.
- 30 patients underwent PTx within 3 years of transplantation.
- 64 patients received cinacalcet 1 year post-transplantation.
Main Results:
- Both cinacalcet and PTx normalized serum calcium levels.
- PTx normalized PTH levels (median 3.7 pmol/L), while cinacalcet did not (median 22.0 pmol/L).
- Minor complications occurred with cinacalcet; 10% of PTx patients required re-exploration.
Conclusions:
- Cinacalcet normalizes calcium but not PTH in tHPT patients.
- PTx normalizes both calcium and PTH, indicating it as the treatment of choice.
- PTx is recommended for optimal management of tHPT post-kidney transplantation.
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