Total parathyroidectomy without autotransplantation in dialysis patients and renal transplant recipients, long-term follow-up evaluation. 2009

Spiros Drakopoulos, and Maria Koukoulaki, and Theofanis Apostolou, and Dimitrios Pistolas, and Katerina Balaska, and Stylianos Gavriil, and Valsamakis Hadjiconstantinou
Transplant Unit, Evangelismos General Hospital of Athens, 45-47 Ipsilantou Street, Athens 10676, Greece.

BACKGROUND Persistent secondary hyperparathyroidism not responding to medication is treated successfully with surgical excision of parathyroid glands (total parathyroidectomy [PTX]). PTX without autotransplantation of parathyroid glands excludes the risk for recurrence of hyperparathyroidism. METHODS During the years 2002 to 2005, 36 total parathyroidectomies were performed in 33 patients: 21 dialysis patients because of end-stage renal disease and 12 renal transplant recipients. RESULTS PTX without autotransplantation was performed successfully in 33 patients, whereas 3 patients were reoperated for remaining parathyroid glands. Immediate improvement of clinical symptoms and a decrease of serum calcium and parathormone levels were observed after surgical procedures. Oral replacement treatment with vitamin D (1a-calcidiol) and calcium was commenced and long-term follow-up evaluation (23.5 +/- 7.6 mo) showed that calcium homeostasis was controlled adequately. CONCLUSIONS PTX without autotransplantation is a safe and effective surgical procedure for the treatment of resistant secondary hyperparathyroidism with immediate response of clinical symptoms. Replacement treatment with vitamin D and calcium provides satisfactory coverage of individual needs.

UI MeSH Term Description Entries
D006962 Hyperparathyroidism, Secondary Abnormally elevated PARATHYROID HORMONE secretion as a response to HYPOCALCEMIA. It is caused by chronic KIDNEY FAILURE or other abnormalities in the controls of bone and mineral metabolism, leading to various BONE DISEASES, such as RENAL OSTEODYSTROPHY. Secondary Hyperparathyroidism,Hyperparathyroidisms, Secondary,Secondary Hyperparathyroidisms
D007676 Kidney Failure, Chronic The end-stage of CHRONIC RENAL INSUFFICIENCY. It is characterized by the severe irreversible kidney damage (as measured by the level of PROTEINURIA) and the reduction in GLOMERULAR FILTRATION RATE to less than 15 ml per min (Kidney Foundation: Kidney Disease Outcome Quality Initiative, 2002). These patients generally require HEMODIALYSIS or KIDNEY TRANSPLANTATION. ESRD,End-Stage Renal Disease,Renal Disease, End-Stage,Renal Failure, Chronic,Renal Failure, End-Stage,Chronic Kidney Failure,End-Stage Kidney Disease,Chronic Renal Failure,Disease, End-Stage Kidney,Disease, End-Stage Renal,End Stage Kidney Disease,End Stage Renal Disease,End-Stage Renal Failure,Kidney Disease, End-Stage,Renal Disease, End Stage,Renal Failure, End Stage
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D010280 Parathyroid Glands Two pairs of small oval-shaped glands located in the front and the base of the NECK and adjacent to the two lobes of THYROID GLAND. They secrete PARATHYROID HORMONE that regulates the balance of CALCIUM; PHOSPHORUS; and MAGNESIUM in the body. Gland, Parathyroid,Glands, Parathyroid,Parathyroid Gland
D010281 Parathyroid Hormone A polypeptide hormone (84 amino acid residues) secreted by the PARATHYROID GLANDS which performs the essential role of maintaining intracellular CALCIUM levels in the body. Parathyroid hormone increases intracellular calcium by promoting the release of CALCIUM from BONE, increases the intestinal absorption of calcium, increases the renal tubular reabsorption of calcium, and increases the renal excretion of phosphates. Natpara,PTH (1-84),PTH(1-34),Parathormone,Parathyrin,Parathyroid Hormone (1-34),Parathyroid Hormone (1-84),Parathyroid Hormone Peptide (1-34),Hormone, Parathyroid
D010758 Phosphorus A non-metal element that has the atomic symbol P, atomic number 15, and atomic weight 31. It is an essential element that takes part in a broad variety of biochemical reactions. Black Phosphorus,Phosphorus-31,Red Phosphorus,White Phosphorus,Yellow Phosphorus,Phosphorus 31,Phosphorus, Black,Phosphorus, Red,Phosphorus, White,Phosphorus, Yellow
D011537 Pruritus An intense itching sensation that produces the urge to rub or scratch the skin to obtain relief. Itching,Pruritis
D002114 Calcinosis Pathologic deposition of calcium salts in tissues. Calcification, Pathologic,Calcinosis, Tumoral,Microcalcification,Microcalcinosis,Pathologic Calcification,Calcinoses,Calcinoses, Tumoral,Microcalcifications,Microcalcinoses,Tumoral Calcinoses,Tumoral Calcinosis
D002118 Calcium A basic element found in nearly all tissues. It is a member of the alkaline earth family of metals with the atomic symbol Ca, atomic number 20, and atomic weight 40. Calcium is the most abundant mineral in the body and combines with phosphorus to form calcium phosphate in the bones and teeth. It is essential for the normal functioning of nerves and muscles and plays a role in blood coagulation (as factor IV) and in many enzymatic processes. Coagulation Factor IV,Factor IV,Blood Coagulation Factor IV,Calcium-40,Calcium 40,Factor IV, Coagulation

Related Publications

Spiros Drakopoulos, and Maria Koukoulaki, and Theofanis Apostolou, and Dimitrios Pistolas, and Katerina Balaska, and Stylianos Gavriil, and Valsamakis Hadjiconstantinou
February 2012, International urology and nephrology,
Spiros Drakopoulos, and Maria Koukoulaki, and Theofanis Apostolou, and Dimitrios Pistolas, and Katerina Balaska, and Stylianos Gavriil, and Valsamakis Hadjiconstantinou
August 2008, Archives of surgery (Chicago, Ill. : 1960),
Spiros Drakopoulos, and Maria Koukoulaki, and Theofanis Apostolou, and Dimitrios Pistolas, and Katerina Balaska, and Stylianos Gavriil, and Valsamakis Hadjiconstantinou
August 2023, Gland surgery,
Spiros Drakopoulos, and Maria Koukoulaki, and Theofanis Apostolou, and Dimitrios Pistolas, and Katerina Balaska, and Stylianos Gavriil, and Valsamakis Hadjiconstantinou
January 1999, Mineral and electrolyte metabolism,
Spiros Drakopoulos, and Maria Koukoulaki, and Theofanis Apostolou, and Dimitrios Pistolas, and Katerina Balaska, and Stylianos Gavriil, and Valsamakis Hadjiconstantinou
November 1994, QJM : monthly journal of the Association of Physicians,
Spiros Drakopoulos, and Maria Koukoulaki, and Theofanis Apostolou, and Dimitrios Pistolas, and Katerina Balaska, and Stylianos Gavriil, and Valsamakis Hadjiconstantinou
August 1994, Transplantation proceedings,
Spiros Drakopoulos, and Maria Koukoulaki, and Theofanis Apostolou, and Dimitrios Pistolas, and Katerina Balaska, and Stylianos Gavriil, and Valsamakis Hadjiconstantinou
January 1998, Transplant international : official journal of the European Society for Organ Transplantation,
Spiros Drakopoulos, and Maria Koukoulaki, and Theofanis Apostolou, and Dimitrios Pistolas, and Katerina Balaska, and Stylianos Gavriil, and Valsamakis Hadjiconstantinou
November 2010, The British journal of surgery,
Spiros Drakopoulos, and Maria Koukoulaki, and Theofanis Apostolou, and Dimitrios Pistolas, and Katerina Balaska, and Stylianos Gavriil, and Valsamakis Hadjiconstantinou
June 2019, Journal of the American College of Surgeons,
Spiros Drakopoulos, and Maria Koukoulaki, and Theofanis Apostolou, and Dimitrios Pistolas, and Katerina Balaska, and Stylianos Gavriil, and Valsamakis Hadjiconstantinou
January 1999, Transplantation proceedings,
Copied contents to your clipboard!