Refractory renal hyperparathyroidism: clinical features and outcome of surgical therapy

Mchenry, Christopher R.; Wilhelm, Scott M.; Ricanati, Edmond; McHenry, C R; Wilhelm, S M; Ricanati, E
April 2001
American Surgeon;Apr2001, Vol. 67 Issue 4, p310
Academic Journal
journal article
Despite improvements in medical management parathyroidectomy has an important role in treatment of refractory renal hyperparathyroidism (HPT). The medical records of all patients who underwent parathyroidectomy from 1991 through 2000 were reviewed to determine the clinical and laboratory features and outcomes of treatment in patients with renal versus primary HPT. Twenty-one of 92 patients who underwent parathyroidectomy had renal HPT with a mean age of 47+/-3 years compared with 56+/-2 years for patients with primary HPT (P < 0.05). Clinical manifestations included osteodystrophy (19), pruritus (six), extraosseous calcification (three), and calciphylaxis (one). Parathyroid hormone, phosphorus, and alkaline phosphatase levels and weights of excised glands were higher in renal versus primary HPT (P < 0.05). Supernumerary glands were found in three patients (14%) with renal HPT and none of nine patients with primary parathyroid hyperplasia. After surgical therapy persistent or recurrent HPT occurred in three (14%) patients with renal and one (1.4%) patient with primary HPT (P < 0.05). Postoperative hypocalcemia occurred in 20 (95%) patients with renal HPT all of whom required intravenous calcium, compared with 25 (35%) patients with primary HPT (P < 0.05) of whom only three (4%) required intravenous calcium (P < 0.05). In contrast to those with primary HPT patients with renal HPT are younger and more likely to have severe osteodystrophy, postoperative hypocalcemia, and persistent or recurrent HPT.


Related Articles

  • Use of Phosphorus Binders among Non-Dialysis Chronic Kidney Disease Patients and Mortality Outcomes. Bhandari, Simran K.; Liu, In-Lu a.; Kujubu, Dean a.; Huynh, Trung; Behayaa, Hind; Kovesdy, Csaba P.; Kalantar-Zadeh, Kamyar; Jacobsen, Steven J.; Sim, John J. // American Journal of Nephrology;May2017, Vol. 45 Issue 5, p431 

    Background: Whether the benefits of phosphorus binders extend to those without end stage renal disease is uncertain. Among a large diverse non-dialysis chronic kidney disease (CKD) population with hyperphosphatemia, we sought to evaluate phosphorus binder use and compare mortality...

  • Use of Extended-Release Calcifediol to Treat Secondary Hyperparathyroidism in Stages 3 and 4 Chronic Kidney Disease. Sprague, Stuart M.; Crawford, Paul W.; Melnick, Joel Z.; Strugnell, Stephen a.; ali, Shaukat; Mangoo-Karim, Roberto; Lee, Sungchun; Petkovich, P. Martin; Bishop, Charles W. // American Journal of Nephrology;Oct2016, Vol. 44 Issue 4, p316 

    Background/aims: Vitamin D insufficiency and secondary hyperparathyroidism (SHPT) are associated with increased morbidity and mortality in chronic kidney disease (CKD) and are poorly addressed by current treatments. The present clinical studies evaluated extended-release (ER)...

  • Changes in Markers of Mineral and Bone Disorders and Mortality in Incident Hemodialysis Patients. Soohoo, Melissa; Feng, Mingliang; Obi, Yoshitsugu; Streja, Elani; Rhee, Connie M.; Lau, Wei Ling; Wang, Jialin; Ravel, Vanessa a.; Brunelli, Steven; Kovesdy, Csaba P.; Kalantar-Zadeh, Kamyar // American Journal of Nephrology;Apr2016, Vol. 43 Issue 2, p85 

    Background: Abnormalities in mineral and bone disorder (MBD) markers are common in patients with chronic kidney disease. However, previous studies have not accounted for their changes over time, and it is unclear whether these changes are associated with survival. Methods:...

  • Anti-N-Methyl-d-Aspartate Receptor Encephalitis in Adult Patients Requiring Intensive Care. de Montmollin, Etienne; Demeret, Sophie; Brulé, Noëlle; Conrad, Marie; Dailler, Frédéric; Lerolle, Nicolas; Navellou, Jean-Christophe; Schwebel, Carole; Alves, Mikaël; Cour, Martin; Engrand, Nicolas; Tonnelier, Jean-Marie; Maury, Eric; Ruckly, Stéphane; Picard, Géraldine; Rogemond, Véronique; Magalhaes, Éric; Sharshar, Tarek; Timsit, Jean-François; Honnorat, Jérôme // American Journal of Respiratory & Critical Care Medicine;2/15/2017, Vol. 195 Issue 4, p491 

    Rationale: Encephalitis caused by anti-N-methyl-d-aspartate receptor (NMDAR) antibodies is the leading cause of immune-mediated encephalitis. There are limited data on intensive care unit (ICU) management of these patients.Objectives: To identify prognostic factors of...

  • Intravenous amiodarone during prolonged resuscitation from cardiac arrest. Williams, Marcus L.; Woelfel, Alan; Cascio, Wayne E.; Simpson Jr., Ross J.; Gettes, Leonard S.; Foster, James R.; Williams, M L; Woelfel, A; Cascio, W E; Simpson, R J Jr; Gettes, L S; Foster, J R // Annals of Internal Medicine;5/15/89, Vol. 110 Issue 10, p839 

    Provides information on a study that used intravenous amiodarone for the treatment of patients during prolonged in-hospital resuscitation from refractory cardiac arrest. Diseases of the patients; Result of intial rescucitative efforts; Effect of intravenous amiodarone.

  • Patiromer Decreases Serum Potassium and Phosphate Levels in Patients on Hemodialysis. Bushinsky, David A.; Rossignol, Patrick; Spiegel, David M.; Benton, Wade W.; Jinwei Yuan; Block, Geoffrey A.; Wilcox, Christopher S.; Agarwal, Rajiv; Yuan, Jinwei // American Journal of Nephrology;Nov2016, Vol. 44 Issue 5, p404 

    Background: Persistent hyperkalemia (serum potassium (K) ≥5.5 mEq/l) is a common condition in hemodialysis (HD) patients, is associated with increased mortality, and treatment options are limited. The effect of patiromer, a gastrointestinal K binder, on serum K was examined in...

  • Treatment of Secondary Hyperparathyroidism: Results of a Phase 2 Trial Evaluating an Intravenous Peptide Agonist of the Calcium-Sensing Receptor. Bushinsky, David a.; Block, Geoffrey a.; Martin, Kevin J.; Bell, Gregory; Huang, Saling; Sun, Yan; Spiegel, David M.; Walsh, Liron; Mix, T. Christian; Kewalramani, Reshma // American Journal of Nephrology;Jan2016, Vol. 42 Issue 5, p379 

    Background/aims: This study evaluated the efficacy and safety of AMG416 (etelcalcitide), a novel peptide agonist of the calcium (Ca)-sensing receptor given intravenously (IV) after each hemodialysis session for the treatment of secondary hyperparathyroidism (SHPT).Methods:...

  • Drug-Eluting Balloon Angioplasty for Below the Knee Lesions in End Stage Renal Disease Patients with Critical Limb Ischemia: Midterm Results. Teymen, Burak; Aktürk, Süleyman // Journal of Interventional Cardiology;Feb2017, Vol. 30 Issue 1, p93 

    Background: The 1-year restenosis rate after standard balloon angioplasty (BA) of long lesions in below-the-knee arteries may be as high as 70%. Our aim was to investigate the efficacy and safety of paclitaxel drug-eluting balloon (DEB) for treatment of below the knee lesions in end...

  • Rationale and Design of a Clinical Trial Investigating Tolvaptan Safety and Efficacy in Autosomal Dominant Polycystic Kidney Disease. Torres, Vicente E.; Devuyst, Olivier; Chapman, arlene B.; Gansevoort, Ron T.; Perrone, Ronald D.; Ouyang, John; Blais, Jaime D.; Czerwiec, Frank S.; Sergeyeva, Olga // American Journal of Nephrology;Mar2017, Vol. 45 Issue 3, p257 

    Background: In TEMPO 3:4, the vasopressin V2-receptor antagonist tolvaptan slowed kidney growth and function decline in autosomal dominant polycystic kidney disease (ADPKD) patients with relatively preserved kidney function.Methods: Prospective, phase 3b, multi-center,...

  • Chronic kidney disease and the risk of end-stage renal disease versus death. Dalrymple, Lorien S.; Katz, Ronit; Kestenbaum, Bryan; Shlipak, Michael G.; Sarnak, Mark J.; Stehman-Breen, Catherine; Seliger, Stephen; Siscovick, David; Newman, Anne B.; Fried, Linda // JGIM: Journal of General Internal Medicine;Apr2011, Vol. 26 Issue 4, p379 

    Background: Among older adults with chronic kidney disease (CKD), the comparative event rates of end-stage renal disease (ESRD) and cause-specific death are unknown.Objective: To compare the rates of ESRD, cardiovascular and non-cardiovascular death and examine risk...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics