| Recurrence of hyperparathyroidism after total parathyroidectomy and autotransplantation in peritoneal dialysis patients. | |
| | |
MedLine Citation:
|
PMID: 10809244 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
OBJECTIVE: To evaluate the effectiveness of total parathyroidectomy (PTX) with autotransplantation in the treatment of secondary hyperparathyroidism (HPT), and to assess recurrence rate of HPT in this peritoneal dialysis (PD) population. DESIGN: A retrospective study in a single home PD unit. PATIENTS: Between 1994 and 1998, 19 of 574 patients on PD underwent PTX for treatment of secondary HPT. MAIN OUTCOME MEASURES: Clinical and biochemical improvement, recurrence of HPT, improvement in anemia post-PTX. RESULTS: Nineteen (3.3%) patients required PTX between 1994 and 1998. These 5 men and 14 women ranged in age from 22 to 66 years; they had been on maintenance PD pre-PTX for 47.5 +/- 38.1 months, and were followed for 26.1 +/- 15.5 months post-PTX. Sixteen patients had temporary hypocalcemia that was managed by oral (n = 10) or intravenous (n = 6) calcium supplements and calcitriol, while 3 patients had severe "hungry bone" syndrome postoperatively. One patient had recurrent laryngeal nerve palsy post-PTX. Bone pain disappeared in all 12 patients. Pruritus improved in 12/13 patients; fatigue improved in 15/16 patients. Comparison showed significant differences between hemoglobin and hematocrit values 1 month pre-PTX and 12 months post-PTX (p < 0.05). Parathyroid hormone (PTH) level in 15 (79%) patients returned to normal (< or = 7.6 pmol/L) during the first month post-PTX. In 5/12 (42%) patients, PTH level was < or = 7.6 pmol/L 2 years post-PTX, while in 2/12 (17%), PTH was > 22.8 pmol/L (three times normal) 2 years post-PTX, and 3/5 (60%) patients had a PTH > 22.8 pmol/L 3 years post-PTX. CONCLUSIONS: Total PTX with autotransplantation is associated with a tendency for recurrence of HPT. Our findings suggest that total PTX with autotransplantation may be an ineffective procedure in controlling HPT over the long term. |
| | |
Authors:
|
A Zhong; V Billa; L E Rotstein; P Y Wong; J M Bargman; S I Vas; D G Oreopoulos |
Related Documents
:
|
9752804 - Sclerotherapy with ok-432 for recurrent cystic thyroid nodule. 17224274 - A comparison of outcomes after robotic open extended thymectomy for myasthenia gravis. 1483874 - Should patients with medullary thyroid carcinoma undergo extensive lymph node (re)opera... 15490064 - Clinical analysis of thyroid cancer in adult patients exposed to ionizing radiation due... 20666194 - Sustained clearance of superficial basal cell carcinomas treated with imiquimod cream 5... 16059764 - Mechanical thrombectomy of occluded hemodialysis native fistulas and grafts using a hyd... |
Publication Detail:
|
Type: Journal Article |
Journal Detail:
|
Title: Peritoneal dialysis international : journal of the International Society for Peritoneal Dialysis Volume: 20 ISSN: 0896-8608 ISO Abbreviation: Perit Dial Int Publication Date: 2000 Mar-Apr |
Date Detail:
|
Created Date: 2000-08-01 Completed Date: 2000-08-01 Revised Date: 2009-11-03 |
Medline Journal Info:
|
Nlm Unique ID: 8904033 Medline TA: Perit Dial Int Country: CANADA |
Other Details:
|
Languages: eng Pagination: 200-8 Citation Subset: IM |
Affiliation:
|
Division of Nephrology, The Toronto Hospital and University of Toronto, Ontario, Canada. amzhong@hotmail.com |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Adult Aged Female Humans Hyperparathyroidism / etiology, surgery* Male Middle Aged Parathyroid Glands / transplantation* Parathyroidectomy* Peritoneal Dialysis* Recurrence Retrospective Studies |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Clinical outcomes of immediate full-volume exchange one year after peritoneal catheter implantation ...
Next Document: Exit-site care with ciprofloxacin otologic solution prevents polyurethane catheter infection in peri...