Surgical Treatment for Renal Hyperparathyroidism : Report of 23 Cases

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Title ( eng )
Surgical Treatment for Renal Hyperparathyroidism : Report of 23 Cases
Creator
Marubayashi Seiji
Fukuda Yasuhiko
Watanabe Hiroshi
Matsusaka Chiko
Oshiro Yoshio
Nitta Kohsaku
Yahata Hiroshi
Asahara Toshimasa
Dohi Kiyohiko
Harada Satoru
Tatsukawa Yorimitsu
Kamikawa Hiroyuki
Ookubo Takashi
Sasaki Hiroshi
Yamashita Tatsuhiro
Yasuda Katsuki
Nakayama Hirofumi
Ito Hisao
Source Title
Hiroshima Journal of Medical Sciences
Volume 41
Issue 1
Start Page 7
End Page 11
Journal Identifire
[PISSN] 0018-2052
[EISSN] 2433-7668
[NCID] AA00664312
Abstract
The present study describes surgical resection in 23 patients under maintenance hemodialysis with hyperparathyroidism. Twenty-three patients under maintenance hemodialysis had subtotal parathyroidectomy (s-PTx, n= 12) or parathyroid gland transplantation combined with total parathyroidectomy (Tx, n= 11) performed from January 1979 to January 1991. Their ages ranged from 8 to 63 years.  

The PTH levels were elevated in all patients preoperatively from 2.5 to 120 times over the upper limit of normal. After s-PTx, PTH levels sharply declined in all but one patient. Clinical symptoms improved in 11 cases with PTH decrease. After Tx, an abrupt decline in PTH was observed after surgery in 10 patients. One patient was reoperated because of persistent hyperparathyroidism. Another patient showed a PTH increase 13 months after surgery. The transplanted parathyroid gland was subtotally resected. Five months after reoperation, the condition recurred and the patient underwent total resection of the transplanted parathyroid gland and its re-autografting into the forearm.  

In the patients with renal hyperparathyroidism, s-PTx or Tx improved clinical symptoms; this indicates the high reliability of both procedures in treating the disease. A long-term follow-up study must be conducted to check the possible postoperative recurrence of hyperparathyroidism from residual and/ or auto graft parathyroid gland.
Keywords
Secondary hyperparathyroidism
Chronic renal failure
Parathyroidectomy
Renal osteodystrophy
NDC
Medical sciences [ 490 ]
Language
eng
Resource Type departmental bulletin paper
Publisher
Hiroshima University Medical Press
Date of Issued 1992-03
Publish Type Version of Record
Access Rights open access
Source Identifier
[ISSN] 0018-2052
[NCID] AA00664312
[PMID] 1572807