Document Detail

Parathyroidectomy in chronic renal failure: short- and long-term results on parathyroid function, blood pressure and anemia.
MedLine Citation:
PMID:  11399918     Owner:  NLM     Status:  MEDLINE    
To evaluate the long-term results of parathyroidectomy (PTX) on parathyroid function, blood pressure and anemia, data of 45 patients with secondary Hyperparathyroidism in dialysis who had undergone PTX were collected retrospectively from 8 different dialysis units. The patients, 25 M and 20 F, mean age 56 +/- 11 years, who were followed up for an average period of 3.3 +/- 2.3 years, were divided into four groups according to the surgical procedure: 19 patients had had a subtotal PTX; 10 patients had undergone total PTX with autotransplantation (AT); 10 patients had had total PTX without AT, and 6 patients had undergone partial PTX. Taking a reduction in intact PTH > 50% as sign of successful PTX, only 5 patients did not attain this result. Considering values of PTH between 20 and 200 pg/ml at the mid-term observation (1-2 years) as the optimal result, values under 20 pg/ml as an expression of permanent hypoparathyroidism, and those above 200 pg/ml as indicating persistent/recurrent hyperparathyroidism, 65.5% of patients operated with subtotal PTX and total PTX + AT had a therapeutic success, versus 31.2% of patients in the other two groups, due to excess permanent hypoparathyroidism and persistent/recurrent hyperparathyroidism; 20 of 45 patients with preoperative hypertension experienced a statistically and clinically significant decrease in blood pressure levels. An increase in serum hemoglobin was also observed, despite a reduction of administered erythropoietin. In conclusion, the results of PTX obtained from this multicenter study are comparable to those reported by single leading centers. Recommended surgical procedures are subtotal PTX and total PTX with AT. The fall in blood pressure in hypertensive patients is clinically significant, and improvement in anemia is also observed with a reduction in erythropoietin dosage.
G Coen; S Calabria; G Bellinghieri; F Pecchini; F Conte; M G Chiappini; M Ferrannini; C Lagona; A Mallamace; M Manni; M DiLuca; D Sardella; F Taggi
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Publication Detail:
Type:  Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Nephron     Volume:  88     ISSN:  0028-2766     ISO Abbreviation:  Nephron     Publication Date:  2001 Jun 
Date Detail:
Created Date:  2001-06-11     Completed Date:  2001-08-09     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0331777     Medline TA:  Nephron     Country:  Switzerland    
Other Details:
Languages:  eng     Pagination:  149-55     Citation Subset:  IM    
Copyright Information:
Copyright 2001 S. Karger AG, Basel
La Sapienza University, Rome, Italy.
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MeSH Terms
Anemia / blood,  prevention & control*
Blood Pressure / physiology*
Hemoglobins / metabolism
Hyperparathyroidism, Secondary / surgery*
Kidney Failure, Chronic / blood,  complications*,  therapy
Middle Aged
Parathyroid Glands / physiopathology*
Parathyroid Hormone / blood
Renal Dialysis / adverse effects*
Retrospective Studies
Reg. No./Substance:
0/Hemoglobins; 0/Parathyroid Hormone

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