Abstract | HYPOTHESIS: DESIGN: A retrospective cohort study. SETTING: University clinic. PATIENTS: MAIN OUTCOME MEASURES: RESULTS: The mean length of follow-up was 31 months in group 1 and 41 months in group 2. In all patients, postoperative serum calcium and phosphate levels normalized and bone pain markedly decreased. Persistent hypocalcemia was not observed. Serum creatinine levels intermittently increased in both groups but returned to preoperative levels in most of the patients. In group 1, all patients had undetectable intact parathyroid hormone levels throughout the study period. In group 2, 2 patients had persistent and 3 patients developed recurrent hyperparathyroidism (31%) that required therapy with cinacalcet hydrochloride in 3 cases. In 4 of these 5 patients, intact parathyroid hormone levels were greater than 54 ng/L directly after operation. In all, 27 of 33 patients (82%) received cholecalciferol therapy. Additional calcium supplementation was used by 12 group 1 patients (71%) and 3 group 2 patients (19%). CONCLUSIONS: Total parathyroidectomy in kidney transplant recipients appears to be safe and protective against persistent and recurrent disease. If subtotal parathyroidectomy is performed, the remnant should be small.
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Authors | Nada Rayes, Daniel Seehofer, Ralf Schindler, Petra Reinke, Andreas Kahl, Frank Ulrich, Peter Neuhaus, Natascha C Nüssler |
Journal | Archives of surgery (Chicago, Ill. : 1960)
(Arch Surg)
Vol. 143
Issue 8
Pg. 756-61; discussion 761
(Aug 2008)
ISSN: 1538-3644 [Electronic] United States |
PMID | 18711035
(Publication Type: Journal Article)
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Topics |
- Adult
- Aged
- Female
- Humans
- Hyperparathyroidism, Secondary
(surgery)
- Kidney Transplantation
- Male
- Middle Aged
- Parathyroid Glands
(transplantation)
- Parathyroidectomy
(methods)
- Retrospective Studies
- Transplantation, Autologous
- Treatment Outcome
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