Total Parathyroidectomy with Forearm Autotransplantation as the Treatment of Choice for Secondary Hyperparathyroidism

Chronic kidney disease—mineral and bone disease (CKD—MBD) is associated with uraemic bone disease, vascular calcification, reduced quality of life and reduced survival. This study evaluated the efficacy of parathyroidectomy (PTX) with autotransplantation in improving short-term and long-term outcome...

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Bibliographic Details
Published in:Journal of international medical research 2011-06, Vol.39 (3), p.978-987
Main Authors: Naranda, J, Ekart, R, Pečovnik-Balon, B
Format: Article
Language:English
Subjects:
Aged
Female
Forearm
Humans
Hyperparathyroidism, Secondary - surgery
Male
Middle Aged
Monitoring, Physiologic
Parathyroid Glands - transplantation
Parathyroidectomy
Postoperative Period
Transplantation, Autologous
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Summary:Chronic kidney disease—mineral and bone disease (CKD—MBD) is associated with uraemic bone disease, vascular calcification, reduced quality of life and reduced survival. This study evaluated the efficacy of parathyroidectomy (PTX) with autotransplantation in improving short-term and long-term outcomes. Dialysis patients who underwent PTX showed significantly more favourable biochemical parameters after PTX. These changes were accompanied by a lower coronary artery calcification score, reduced thickness of the intimae media and comparable bone mineral density measures compared with control dialysis patients who did not undergo PTX. Despite the risk of a substantially lower intact parathyroid hormone level postoperatively that might lead to adynamic bone disease, none of the patients reported clinical signs of this disease, such as bone pain or fractures. In conclusion, PTX with autotransplantation led to improvement of CKD—MBD so may be considered in patients with secondary hyperparathyroidism that is resistant to treatment with vitamin D analogues and calcimimetics.
ISSN:0300-0605
1473-2300
DOI:10.1177/147323001103900333