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Parathyroidectomy in chronic renal failure.

A Sivula, B Kuhlbäck, B Kock

Acta Chirurgica Scandinavica

|January 1, 1979

Summary

Subtotal parathyroidectomy improved severe symptoms in chronic renal failure patients. However, complete recovery was only seen with successful kidney transplants, suggesting parathyroidectomy is a supportive treatment.

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Area of Science:

Nephrology
Endocrinology
Surgical Pathology

Background:

Chronic renal failure (CRF) frequently leads to secondary hyperparathyroidism.
Grave clinical symptoms, gastric ulcers, and radiological abnormalities indicate severe hyperparathyroidism in CRF patients.
Elevated serum parathyroid hormone levels are characteristic of this condition.

Purpose of the Study:

To evaluate the efficacy of subtotal parathyroidectomy in managing severe secondary hyperparathyroidism in patients with chronic renal failure.
To assess the impact of parathyroidectomy on clinical symptoms, radiological findings, and overall patient condition.

Main Methods:

A retrospective analysis of 34 patients with CRF who underwent subtotal parathyroidectomy between 1971-1976.
Preoperative treatments included conservative therapy, hemodialysis, and renal transplantation.
Surgical intervention involved removing varying amounts of parathyroid tissue, with histological examination for hyperplasia.

Main Results:

Subtotal parathyroidectomy led to significant reductions in serum parathyroid hormone and calcium levels postoperatively.
Patients experienced alleviation of bone pain, pruritus, and mental disturbances, with improved general condition.
Radiological changes showed a slower response, and complete recovery was contingent upon successful renal transplantation.

Conclusions:

Subtotal parathyroidectomy is an effective treatment for alleviating severe symptoms associated with secondary hyperparathyroidism in chronic renal failure.
The procedure offers symptomatic relief and can be considered for specific cases, but renal transplantation remains crucial for complete recovery.

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