Parathyroidectomy and response to erythropoietin therapy in anaemic patients with chronic renal failure

Mandolfo, Salvatore

doi:10.1093/ndt/13.10.2708

Cited by 35 publications

(38 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…14,16,17 The beneficial effect of parathyroidectomy on erythropoiesis has been shown to take place regardless of the administration of recombinant human erythropoietin. 13,16 However, our study cannot demonstrate a significant erythropoietic effect on the subgroup that did not receive recombinant human erythropoietin. This is probably owing to the small sample size, with only 7 patients not receiving the therapy.…”

Section: Commentcontrasting

confidence: 57%

Improvement of Anemia After Parathyroidectomy in Chinese Patients With Renal Failure Undergoing Long-term Dialysis

Chow

Chan²,

Ho³

et al. 2007

Arch Surg

View full text Add to dashboard Cite

show abstract

Section: Commentcontrasting

confidence: 57%

Improvement of Anemia After Parathyroidectomy in Chinese Patients With Renal Failure Undergoing Long-term Dialysis

Chow

Chan²,

Ho³

et al. 2007

Arch Surg

View full text Add to dashboard Cite

show abstract

“…Mandolfo et al (16) also evaluated retrospectively the effect of parathyroidectomy in a cohort of 39 patients. Surgery improved anemia in all, but the improvement in the subset of patients who received EPO was further emphasized by a concomitant 30 to 40% reduction of the weekly administered amount.…”

Section: Effect Of Parathyroidectomymentioning

confidence: 99%

Hyperparathyroidism and Anemia in Uremic Subjects

Brancaccio

Cozzolino²,

Gallieni³

2004

Journal of the American Society of Nephrology

View full text Add to dashboard Cite

Abstract. Several factors are involved in conditioning renal anemia, and a critical role is attributed to parathyroid hormone (PTH) oversecretion, which has some direct effects on endogenous erythropoietin (EPO) synthesis, bone marrow erythroid progenitors, and red cell survival. Indirect effects are mainly based on the induction of bone marrow fibrosis. Indirect evidence of the role of PTH is based on the observation that parathyroidectomy, when performed in uremic patients, is often followed by restoration of the hematocrit. The interpretations of such positive results are based on the observation of the restored bone marrow space after operation and also in a rise of immunoreactive EPO serum concentrations observed in the first weeks after gland removal. Another field of clinical interest is the possible beneficial effects of vitamin D therapy in controlling PTH secretion, which in turn determines an improvement of anemia of uremic subjects. Several uncontrolled studies confirmed this possibility, indicating that patients who respond to calcitriol or its analogs also show an increase of their hemoglobin levels. Thus, a combined therapeutic approach to PTH oversecretion and anemia is possible by intravenous calcitriol or parathyroidectomy pointing to the possible reversibility of bone marrow fibrosis, which is a common feature of secondary hyperparathyroidism. The increased sensitivity to EPO therapy can also induce a successful reduction of its dosage, thus allowing an interesting reduction of costs.

show abstract

“…Meanwhile, intact PTH levels decreased from 1,009 B 287 to 85 B 83 pg/ml. Mandolfo et al [47] retrospectively studied the effect of parathyroidectomy in 39 dialysis patients. The patients were divided into two groups according to Epoetin treatment at the time of parathyroidectomy.…”

Section: Effect Of Parathyroidectomymentioning

confidence: 99%

Hyperparathyroidism and Anemia in Renal Failure

Gallieni¹,

Corsi²,

Brancaccio³

2000

Am J Nephrol

View full text Add to dashboard Cite

Patients with severe secondary hyperparathyroidism, usually associated with osteitis fibrosa on bone histology, show considerable resistance to Epoetin, partly because of replacement of the cellular components of the bone marrow by fibrous tissue. In case of unexplained resistance to Epoetin, investigation of secondary hyperparathyroidism is strongly recommended, with measurement of serum parathyroid hormone, calcium, phosphate, and alkaline phosphatase levels and, where needed, skeletal radiology and bone biopsy. Treatment of severe secondary hyperparathyroidism consists of active vitamin D metabolites or parathyroidectomy, although the marrow fibrosis, if present, may be irreversible. The finding of a progressive inability of the bone marrow to respond to Epoetin treatment with higher levels of parathyroid hormone suggests the importance to prevent metabolic bone disease and in particular secondary hyperparathyroidism. Moreover, there are several reports of a beneficial action on hemoglobin levels of an effective treatment of hyperparathyroidism. Larger, controlled studies are necessary to confirm these preliminary and exciting findings, and to elucidate the mechanisms underlying the improvement in anemia after medical or surgical treatment of hyperparathyroidism.

show abstract

Parathyroidectomy and response to erythropoietin therapy in anaemic patients with chronic renal failure

Cited by 35 publications

References 0 publications

Improvement of Anemia After Parathyroidectomy in Chinese Patients With Renal Failure Undergoing Long-term Dialysis

Improvement of Anemia After Parathyroidectomy in Chinese Patients With Renal Failure Undergoing Long-term Dialysis

Hyperparathyroidism and Anemia in Uremic Subjects

Hyperparathyroidism and Anemia in Renal Failure

Contact Info

Product

Resources

About