<abstract xmlns="http://www.w3.org/1999/xhtml"><p>Secondary hyperparathyroidism (sHPT) occurs most commonly in the setting of chronic renal failure (CRF) being frequently referred to as “renal” hyperparathyroidism The “classical” medical treatment with oral calcium and vitamin D supplementation is generally sufficient to lower parathyroid hormone levels in the majority of these patients. However, we frequently encounter cases of severe refractory sHPT, a state in which even recently available therapeutic agents, i.e. calcimimetics, new phosphate binders, vitamin D analogues, remain inefficient, thus parathyroidectomy and/or renal transplant becoming necessary. Three types of surgeries have been proposed in sHPT: two of them are grouped as remnant-conserving techniques, i.e. subtotal parathyroidectomy (sPtx) and total parathyroidectomy with autotransplantation (tPtx+AT), the third one being total parathyroidectomy without autotransplantation (tPtx). There was a continuous debate concerning the best surgical approach in renal hyperparathyroidism, starting very soon after those techniques were described; without pretending to solve these controversies, this paper aims to review the surgical treatment options in sHPT, based on our 5-year experience in dealing with the disease.</p></abstract>

Secondary hyperparathyroidism (sHPT) occurs most commonly in the setting of chronic renal failure (CRF) being frequently referred to as “renal” hyperparathyroidism The “classical” medical treatment with oral calcium and vitamin D supplementation is generally sufficient to lower parathyroid hormone levels in the majority of these patients. However, we frequently encounter cases of severe refractory sHPT, a state in which even recently available therapeutic agents, i.e. calcimimetics, new phosphate binders, vitamin D analogues, remain inefficient, thus parathyroidectomy and/or renal transplant becoming necessary. Three types of surgeries have been proposed in sHPT: two of them are grouped as remnant-conserving techniques, i.e. subtotal parathyroidectomy (sPtx) and total parathyroidectomy with autotransplantation (tPtx+AT), the third one being total parathyroidectomy without autotransplantation (tPtx). There was a continuous debate concerning the best surgical approach in renal hyperparathyroidism, starting very soon after those techniques were described; without pretending to solve these controversies, this paper aims to review the surgical treatment options in sHPT, based on our 5-year experience in dealing with the disease.

Surgical Management of Renal Hyperparathyroidism: Case Series and Review of the Literature

Second Department of General Surgery, University of Medicine and Pharmacy Tîrgu Mureş, Romania

Centrul de Dializă B Braun Avitum Tîrgu Mures

Nephrology Department, University of Medicine and Pharmacy Târgu Mureş, Romania

Endocrinology Department, University of Medicine and Pharmacy Târgu Mureş, Romania

Department of Histology, University of Medicine and Pharmacy Târgu Mureş, Romania

Acta Marisiensis - Seria Medica

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Secondary hyperparathyroidism (sHPT) occurs most commonly in the setting of chronic renal failure (CRF) being frequently referred to as “renal”...

Surgical Management of Renal Hyperparathyroidism: Case Series and Review of the Literature

Published Online: Jan 19, 2016

Page range: 391 - 395

Received: Jun 15, 2015

Accepted: Aug 04, 2015

DOI: https://doi.org/10.1515/amma-2015-0083

Keywords
renal hyperparathyroidism, subtotal parathyroidectomy, total parathyroidectomy with autotransplant

© 2015 Neagoe Radu Mircea et al., published by De Gruyter Open

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Surgical Management of Renal Hyperparathyroidism: Case Series and Review of the Literature

Published Online: Jan 19, 2016

Page range: 391 - 395

Received: Jun 15, 2015

Accepted: Aug 04, 2015

DOI: https://doi.org/10.1515/amma-2015-0083

Keywordsrenal hyperparathyroidism, subtotal parathyroidectomy, total parathyroidectomy with autotransplant

© 2015 Neagoe Radu Mircea et al., published by De Gruyter Open

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Keywords
renal hyperparathyroidism, subtotal parathyroidectomy, total parathyroidectomy with autotransplant