Surgical Treatment of Hyperparathyroidism After Kidney Transplant

Kovács, D; Fejes, R; Asztalos, László; Andrási, Melinda; Szabó, Réka P.; Kanyári, Zsolt; Barna, Sándor; Nemes, Balázs; Győry, Ferenc

doi:10.1016/j.transproceed.2019.03.008

Cited by 5 publications

(11 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…This is closely related to etiology, course, comorbidities, and other factors. The tendency of iPTH to rebound and hypocalcemia after treatment has been previously demonstrated in several patient populations with THPT [ 19 26 27 28 ]. The reduced renal excretion of phosphorus potentially limited the excretion of phosphorus in the dialysis fluid, affecting subsequent accumulation of phosphorus over months and years resulting in compensatory hyperplasia of the remaining parathyroid tissue.…”

Section: Discussionmentioning

confidence: 99%

“…The reduced renal excretion of phosphorus potentially limited the excretion of phosphorus in the dialysis fluid, affecting subsequent accumulation of phosphorus over months and years resulting in compensatory hyperplasia of the remaining parathyroid tissue. In our experience, RFA can be considered as a viable option for maintaining iPTH and normal calcium levels as its recurrence rate is lower than that of other treatment modalities [ 19 26 27 ].…”

Section: Discussionmentioning

confidence: 99%

“…Based on the definition of THPT in this study, seven articles on PTX (in the last 5 years) and an additional representative alcohol injection article for THPT are listed in Table 4 for additional analysis [ 15 16 17 19 26 27 28 36 ]. The surgery failure rate was defined as the sum of the incidence of persistent and recurrent hyperparathyroidism after treatment.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Ultrasound-Guided Radiofrequency Ablation in Tertiary Hyperparathyroidism: A Prospective Study

Deng,

Jiang,

Chai

et al. 2024

Korean J Radiol

View full text Add to dashboard Cite

Objective To prospectively evaluate the outcomes of ultrasound (US)-guided radiofrequency ablation (RFA) in tertiary hyperparathyroidism (THPT). Materials and Methods Patients with THPT underwent RFA between September 2017 and January 2022. Laboratory parameters, including serum intact parathyroid hormone (iPTH) levels, were monitored for 48 months after RFA and compared with the levels at baseline. Complications related to RFA and changes in hyperparathyroidism-related clinical symptoms were recorded before and after RFA. Results A total of 42 patients with THPT were recruited for this study. Ultimately, 36 patients with renal failure and 2 patients who underwent successful renal transplantation (male:female, 17:21; median age, 54.5 years) were enrolled. The follow-up time was 21.5 ± 19.0 months in the 36 patients with renal failure. In these 36 patients, iPTH levels were significantly decreased to 261.1 pg/mL at 48 months compared with the baseline value of 1284.9 pg/mL ( P = 0.012). Persistent hyperparathyroidism, defined as iPTH levels maintained at > 585.0 pg/mL for 6 months after treatment, occurred in 4.0% of patients (1/25). Recurrent hyperparathyroidism, defined as iPTH levels > 585.0 pg/mL after 6 months, were 4.0% (1/25) and 0.0% (0/9) at 6 months and 4 years after treatment, respectively. In two patients with THPT after successful renal transplantation, iPTH decreased from the baseline value of 242.5 and 115.9 pg/mL to 171.0 and 62.0 pg/mL at 6 months after treatment. All complications resolved within 6 months of ablation without medical intervention, except in 10.5% (4/38) patients with permanent hypocalcemia. The overall symptom recovery rate was 58.8% (10/17). The severity scores for bone pain, arthralgia, and itchy skin associated with hyperparathyroidism improved after treatment ( P < 0.05). Conclusion US-guided RFA is an effective and safe alternative to surgery in the treatment of patients with TPTH and improves hyperparathyroidism-related clinical symptoms.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Ultrasound-Guided Radiofrequency Ablation in Tertiary Hyperparathyroidism: A Prospective Study

Deng,

Jiang,

Chai

et al. 2024

Korean J Radiol

View full text Add to dashboard Cite

show abstract

“…S e v e r a l s t u d i e s h a v e r e p o r t e d t h a t a l l o g r a f t function declined significantly 1-3 months after parathyroidectomy, it gradually recovered, and then it finally improved to the baseline level 12-15 months after parathyroidectomy (3,16). Long-term outcomes were comparable to those in patients who did not undergo parathyroidectomy, and permanent graft dysfunction was rare (6,8,10,45). Patecki et al (45) reported that the median annual change in the eGFR between KT and parathyroidectomy was -0.5 mL/min, and then a significant drop of 25% in the eGFR was observed.…”

Section: 1 T H E N E G a T I V E E Ff E C T O F P O S T -T R A N S P...mentioning

confidence: 93%

“…SHPT is likely to develop to an advanced stage that is resistant to medical treatment such as drug therapy, dialysis, and diet. Untreated or treatment-resistant SHPT results in serious complications such as kidney stones, osteoporosis, vascular calcification, and pathological fractures (3)(4)(5), affecting the quality of life in most patients with ESRD (5,6).…”

Section: Introductionmentioning

confidence: 99%

Timing of parathyroidectomy for kidney transplant patients with secondary hyperparathyroidism: A practical overview

Wang

et al. 2022

BST

View full text Add to dashboard Cite

show abstract

Management of de novo nephrolithiasis after kidney transplantation: a comprehensive review from the European Renal Association CKD-MBD working group

Kanbay,

Copur,

Bakir

et al. 2024

Clinical Kidney Journal

View full text Add to dashboard Cite

The lifetime incidence of kidney stones is 6-12% in the general population. Nephrolithiasis is a known cause of acute and chronic kidney injury, mediated via obstructive uropathy or crystal-induced nephropathy, and several modifiable and non-modifiable genetic and lifestyle causes have been described. Evidence for epidemiology and management of nephrolithiasis after kidney transplantation is limited by low number of publications, small study sizes, and short observational periods. Denervation of the kidney and ureter graft greatly reduces symptomatology of kidney stones in transplant recipients, which may contribute to a considerable underdiagnosis. Thus, reported prevalence rates of 1-2% after kidney transplantation and the lack of adverse effects on allograft function and survival should be interpreted with caution. In this narrative review we summarize current state-of-the-art knowledge regarding epidemiology, clinical presentation, diagnosis, prevention, and therapy of nephrolithiasis after kidney transplantation, including management of asymptomatic stone disease in kidney donors. Our aim is to strengthen clinical nephrologists who treat kidney transplant recipients in informed decision-making regarding management of kidney stones. Available evidence, supporting both surgical and medical treatment and prevention of kidney stones, are presented and critically discussed. The specific anatomy of the transplanted kidney and urinary tract requires deviation from established interventional approaches for nephrolithiasis in native kidneys. Also, pharmacological and lifestyle changes may need adaptation to the specific situation of kidney transplant recipients. Finally, we point out current knowledge gaps and the need for additional evidence from future studies.

show abstract

Surgical Treatment of Hyperparathyroidism After Kidney Transplant

Cited by 5 publications

References 11 publications

Ultrasound-Guided Radiofrequency Ablation in Tertiary Hyperparathyroidism: A Prospective Study

Ultrasound-Guided Radiofrequency Ablation in Tertiary Hyperparathyroidism: A Prospective Study

Timing of parathyroidectomy for kidney transplant patients with secondary hyperparathyroidism: A practical overview

Management of de novo nephrolithiasis after kidney transplantation: a comprehensive review from the European Renal Association CKD-MBD working group

Contact Info

Product

Resources

About