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Acta Medica Colombiana
Print version ISSN 0120-2448
Abstract
SANINT, Valentina; RESTREPO, César Augusto and CHALA, Andrés Ignacio. Experience with surgical parathyroidectomy in patients with chronic kidney disease and tertiary hyperparathyroidism. Acta Med Colomb [online]. 2018, vol.43, n.3, pp.136-141. ISSN 0120-2448.
Introduction:
tertiary hyperparathyroidism is the final consequence of alterations in calcium-phosphorus metabolism in patients with chronic kidney disease. Those patients who fail to control it with medical treatment require parathyroidectomy.
Objective:
go describe the clinical and paraclinical evolution in patients with chronic kidney disease and diagnosis of tertiary hyperparathyroidism, who underwent parathyroidectomy.
Methodology:
prospective study, which included patients with tertiary hyperparathyroidism taken to parathyroidectomy between 2006 and 2015. Pre and post-surgical biochemical studies were performed and the presence and progression of symptoms was evaluated.
Results:
32 patients were included. 68.8 (%) were women with an average age of 46.2 years. Statistically significant differences were identified in the change in calcium, phosphorus and PTH values before and after surgery. 81.5% of patients reported the presence of symptoms. 34.6, 26.9, and 23% presented total improvement of bone pain, joint pain and pruritus, respectively. 28% presented postoperative symptomatic hypocalcemia. There were no deaths during follow-up.
Conclusions:
parathyroidectomy is a safe and reliable alternative for patients with tertiary hyper-parathyroidism, significantly improving symptoms and alterations in bone and mineral metabolism. Monitoring calcium levels in the postoperative period is important to avoid the complications of the hungry bone syndrome.
Keywords : chronic renal failure; hyperparathyroidism; parathyroidectomy; renal osteodystrophy; dialysis; kidney transplant.