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[Secondary hyperparathyroidism]

M R Diaconescu1, I Costea, R Terinte

  • 1Clinica a IV-a Chirurgie, Universitatea de Medicină şi Farmacie Gr. T. Popa, Iaşi.

Chirurgia (Bucharest, Romania : 1990)
|January 1, 1995
PubMed
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Secondary hyperparathyroidism in chronic renal failure patients can be treated with subtotal parathyroidectomy. This surgery improved clinical, radiological, and biochemical markers in two patients on chronic dialysis.

Area of Science:

  • Nephrology
  • Endocrinology
  • Surgical Pathology

Background:

  • Secondary hyperparathyroidism is a complication of chronic renal failure (CRF) and conditions affecting nutrient absorption, such as rickets and osteomalacia.
  • Patients on chronic dialysis are particularly susceptible to secondary hyperparathyroidism due to impaired calcium and vitamin D metabolism.

Observation:

  • Two patients with CRF on long-term hemodialysis presented with severe bone pain, itching, demineralization, ectopic calcifications, hypercalcemia, hyperphosphatemia, and elevated alkaline phosphatases.
  • Both patients underwent subtotal parathyroidectomy, involving the removal of three parathyroid glands and preservation of half a gland in situ.

Findings:

  • Postoperatively, patients exhibited significant improvement in clinical symptoms, laboratory values (calcium, phosphorus, alkaline phosphatase), and radiological parameters.

Related Experiment Videos

  • The study highlights the effectiveness of subtotal parathyroidectomy in managing severe secondary hyperparathyroidism in dialysis patients.

    • Implications:

    • Subtotal parathyroidectomy is a viable surgical option for secondary hyperparathyroidism refractory to conservative management.
    • The choice between subtotal parathyroidectomy and total parathyroidectomy with autotransplantation remains a matter of surgical preference, with both aiming to resolve hyperparathyroidism complications.