[Efficiency of total parathyroidectomy and autotransplantation in 31 patients with uremic hyperparathyroidism].

Abstract

OBJECTIVE:

To analyse the efficacy of total parathyroidectomy with autotransplantation (total PTX + AT) in treating uremic secondary hyperparathyroidism and to discuss the relevant medical treatment used.

METHODS:

The clinical data of 31 patients with uremic SHPT admitted into our hospital from 1996-2005 were analysed with respect to total PTX + AT.

RESULTS:

The period of hemodialysis were for the patients was on the average 9.2 years. There were 22 male and 9 female with an average age of 42.4 (31 - 67) years. The clinical manifestations consisted of osteoarticular pain in 83.9%, fractures in 35.5%, soft tissue and vascular calcification in 45.2% and pruritus in 80.6%. Laboratory examination yielded the following results: haematocrit 0.25 +/- 0.04, serum Ca (2.61 +/- 0.35) mmol/L, serum P (2.14 +/- 0.31) mmol/L, plasma total alkaline phosphatase (AKP) (885 +/- 335) U/L and parathyroid hormone (iPTH) (1811 +/- 879) ng/L (700 - 2500 ng/L). Cervical ultrasonography and/or emission computed tomography showed 2 - 4 hyperplastic glands. All of the patients showed no response to medical treatment including vitamin D. Total PTX + AT was performed on the 31 cases. Clinical symptoms and signs markedly improved after operation in 1 to 2 weeks. However, fracture and ectopic calcification showed no improvement. Plasma iPTH decreased rapidly (< 200 ng/L) postoperatively in 1 to 2 days. Serum Ca and P returned to normal. AKP was corrected in 1 to 3 months.

CONCLUSION:

Total parathyroidectomy with autotransplantation is an effective treatment for severe uremic secondary hyperparathyroidism patients.

• Authors: Jian-ming Hu, Hong-fei Wu, Xiao-yun Wang, Xiang-bao Yu, Yi-hua Zhao, Xia Shen, Jia Liu, Bin Sun, Chang-ying Xing, Jun-wei Yang
• Journal: Zhonghua nei ke za zhi (Zhonghua Nei Ke Za Zhi) Vol. 45 Issue 9 Pg. 714-6 (Sep 2006) ISSN: 0578-1426 [Print] China
• PMID: 17166442 (Publication Type: English Abstract, Journal Article, Research Support, Non-U.S. Gov't)

Topics

• Adult
• Aged
• Female
• Humans
• Hyperparathyroidism, Secondary (etiology, surgery)
• Male
• Middle Aged
• Parathyroid Glands (surgery)
• Parathyroidectomy (methods)
• Renal Dialysis
• Retrospective Studies
• Transplantation, Autologous
• Uremia (complications)