Evolution of renal function in patients with primary hyperparathyroidism submitted to parathyroidectomy

Abstract

Financial support: None. Conflicts of interest: No conflicts of interest declared concerning the publication of this article.

Outcome of subtotal parathyroidectomy for surgical treatment of hyperparathyroidism after renal transplantation

“…Despite the fact that subtotal parathyroidectomies may have an increased risk of recurrent HPT (from 5% to 30%) compared to total parathyroidectomies, the subtotal parathyroidectomies are associated with lower rates of hypoparathyroidism and preservation of renal function 14,16,17 . There is evidence that removal of parathyroid tissue accompanied by an abrupt decrease in PTH is related to worsening renal function, possibly due to the loss of the vasodilatory effect of PTH in afferent renal arteriole and vasoconstrictor effect in efferent renal arteriole 15,18 . Studies concerning the link between extension of the surgical procedure and renal function showed a worsening renal transplant function in the total parathyroidectomy group when data are compared to the subtotal parathyroidectomy group 11,16 . Currently, even if the sample size is limited to the statistical analysis, no patient had renal graft loss or hypoparathyroidism after six-months of follow-up, and the therapeutic failure rate showed 13% of effectiveness, and these data are in accordance to the average results presented in literature.…”