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A New Approach to Tertiary Hyperparathyroidism: Percutaneous Embolization: Two Case Reports.
Neriman Sila Koc1, Rahmi Yilmaz1, Tolga Yildirim1
1Department of Nephrology, Hacettepe University Faculty of Medicine, Altındag, Ankara, Turkey.
Transplantation Proceedings
|September 21, 2020
Summary
Tertiary hyperparathyroidism, a complication of chronic kidney disease, can be treated with percutaneous embolization. This minimally invasive procedure offers a new option for renal transplant patients when other treatments fail.
Area of Science:
- Nephrology
- Endocrinology
- Interventional Radiology
Background:
- Secondary hyperparathyroidism is a common complication of chronic kidney failure.
- Prolonged secondary hyperparathyroidism can lead to autonomous parathyroid hormone release, resulting in tertiary hyperparathyroidism, often associated with parathyroid adenoma or hyperplasia.
- Tertiary hyperparathyroidism increases mortality and morbidity risks, necessitating effective treatment strategies.
Observation:
- Medical management, including phosphate binders, vitamin D analogues, and calcimimetics, controls most tertiary hyperparathyroidism cases.
- Parathyroidectomy is recommended when medical treatments are insufficient.
- Recurrence after parathyroidectomy necessitates alternative therapeutic approaches.
Findings:
- This study explores percutaneous embolization as a treatment for tertiary hyperparathyroidism.
- Percutaneous embolization has not previously been documented for treating tertiary hyperparathyroidism in renal transplant recipients.
Implications:
- Percutaneous embolization may offer a viable alternative treatment for tertiary hyperparathyroidism in renal transplant patients.
- This approach could address treatment-resistant cases and post-parathyroidectomy recurrence.
- Further research is warranted to establish the efficacy and safety of percutaneous embolization in this specific patient population.
