Tratamiento quirúrgico del hiperparatiroidismo asociado a insuficiencia renal crónica: Experience in 71 patients / Surgical treatment of renal hyperparathyroidism
Rev. méd. Chile
; 143(2): 190-196, feb. 2015. ilus, tab
Article
in Es
| LILACS
| ID: lil-742570
Responsible library:
CL1.1
ABSTRACT
Background:
Surgery is an effective method for the management of renal hyperparathyroidism.Aim:
To report the clinical presentation and results of surgical treatment of renal hyperparathyroidism. Material andMethods:
Retrospective analysis of 58 patients aged 46 ± 11 years with secondary hyperparathyroidism (HPT2) and 13 patients aged 53 ± 11 years with tertiary hyperparathyroidism (HPT3), operated at a clinical hospital.Results:
In 55 cases (77.4%) the indications for surgery were complications of excess parathyroid hormone (PTH) and in 16 patients (22.6%) a failure of medical treatment. Total parathyroidectomy with intraoperative measurement of PTH (PTHop) plus a forearm parathyroid autograft was performed in 54 (93.1%) patients with HPT2 and in all patients with HPT3. PTHop decreased ≥ 75% in 51 patients (88%) with HPT2 and in 9 patients (69.2%) with HPT3, respectively. Cure of the disease was achieved in 52 (89.7%) and 11 (84.6%) patients with HPT2 and 3, respectively. Median follow-up was 41 months. Five (9.6%) patients with HPT2 and two patients (18.2%) with HPT3 had a recurrence of the disease.Conclusions:
In patients with renal hyperparathyroidism, the primary indication for surgery was the presence of complications of PTH excess. A drop in PTHop ≥ 75% from baseline predicts healing in 98% and 100% of cases with secondary or tertiary HPT respectively. Surgery was a safe and effective treatment in both groups.Key words
Full text:
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Index:
LILACS
Main subject:
Carbohydrate Dehydrogenases
/
Polymorphism, Single Nucleotide
/
Carotid Intima-Media Thickness
Type of study:
Etiology_studies
/
Prognostic_studies
/
Risk_factors_studies
Limits:
Adult
/
Aged
/
Aged80
/
Female
/
Humans
/
Male
Language:
Es
Journal:
Rev. méd. Chile
Journal subject:
MEDICINA
Year:
2015
Type:
Article