[Subtotal parathyroidectomy in the advanced stages of renal osteodystrophy]

In 7 haemodialysis patients with progressing renal osteopathy a partly subtotal, partly total parathyroidectomy was carried out. Postoperatively in all cases a clinical improvement developed, which, however, in part was only transient. The laboratory parameters showed a rapid tendency to normalisation, the X-ray diagnostic finding and the bone mineral content remained essentially unchanged, also the histological skeletal findings. The results are compiled in form of tables. The value of the diagnostic measures which should precede a subtotal parathyroidectomy is discussed. At present the different postoperative courses apparently cannot be prospectively estimated with the help of the hitherto usual diagnostic measures. On the basis of the partly good results and of the operation risk which is to be thoroughly demanded of a haemodialysis patient it seems that after having used all conservative possibilities the surgical interventions nevertheless indicated in progressing renal osteopathy.