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Establishment of a Simple and Effective Rat Model for Intraoperative Parathyroid Gland Imaging
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Surgery for kidney-related hyperparathyroidism: A review
Julia Adriana Kasmirski1, Niranjna Swaminathan1, Raj Roy1
1Department of Surgery, The University of Alabama at Birmingham, Birmingham, AL, USA.
American Journal of Surgery
|February 15, 2026
Summary
Secondary hyperparathyroidism, often linked to chronic kidney disease (CKD), can persist post-transplant as tertiary hyperparathyroidism. This review covers diagnosis, treatments, and surgical strategies for improved parathyroid disease cure rates.
Area of Science:
- Nephrology and Endocrinology
- Mineral and Bone Disorders
Background:
- Secondary hyperparathyroidism is a common complication of chronic kidney disease (CKD), disrupting calcium and phosphorus balance.
- Kidney transplantation can restore homeostasis, leading to remission in some patients, but others develop tertiary hyperparathyroidism due to autonomous parathyroid hormone secretion.
Purpose of the Study:
- To review the diagnostic approaches for secondary and tertiary hyperparathyroidism.
- To explore current medical and surgical treatment options for persistent parathyroid gland disease.
- To identify strategies for enhancing the success rates of parathyroidectomy.
Main Methods:
- Literature review of diagnostic criteria and clinical presentations.
- Analysis of medical management protocols for hyperparathyroidism.
- Evaluation of contemporary surgical techniques and outcomes in parathyroidectomy.
Main Results:
- Persistent hyperparathyroidism post-transplantation indicates autonomous parathyroid function (tertiary hyperparathyroidism).
- A comprehensive approach combining medical therapy and surgical intervention is often necessary.
- Optimizing surgical techniques may improve cure rates and reduce recurrence.
Conclusions:
- Tertiary hyperparathyroidism requires specific management strategies beyond kidney transplantation.
- Parathyroidectomy remains a key intervention for refractory cases, with evolving techniques.
- Further research into optimizing surgical outcomes is warranted to improve patient cure rates.
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