Total Parathyroidectomy: A Surgical Management for Uncontrolled Secondary Hyperparathyroidism in a Patient with End Stage Renal Disease

Objective: To present the case of an adult patient with end stage renal disease who underwent total parathyroidectomy with autotransplantation for uncontrolled secondary hyperparathyroidism Methods: Design: Case Report Setting: Tertiary Hospital Patient: One Result: Total parathyroidectomy with autotransplantation resulted in decrease in parathyroid hormone from a pre-operative value of 1,347pg/mL (15-65 pg/mL) to 28.05 pg/mL. Pruritus disappeared two days after the surgery. Phosphorus and calcium levels were within normal values four days and two months post-operatively, respectively. Conclusion: Total parathyroidectomy with autotransplantation may be a viable surgical option for controlling secondary hyperparathyroidism associated with end stage renal disease and may play an important role in reducing morbidity and mortality among patients with end-stage renal disease. Keywords: Secondary hyperparathyroidism, parathyroidectomy, autotransplantation, end- stage renal disease, hungry bone syndrome, parathyroid hormone

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Changes in bone mineral density after total parathyroidectomy without autotransplantation in the end-stage renal disease patients with secondary hyperparathyroidism

BMC Nephrology ◽

10.1186/s12882-018-0934-1 ◽

2018 ◽

Vol 19 (1) ◽

Cited By ~ 4

Author(s):

Li Fang ◽

Jining Wu ◽

Jing Luo ◽

Ping Wen ◽

Mingxia Xiong ◽

...

Keyword(s):

Bone Mineral Density ◽

Renal Disease ◽

Secondary Hyperparathyroidism ◽

Bone Mineral ◽

End Stage Renal Disease ◽

Total Parathyroidectomy ◽

Mineral Density ◽

Stage Renal Disease ◽

End Stage

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The Calcimimetic Agent AMG 073 Lowers Plasma Parathyroid Hormone Levels in Hemodialysis Patients with Secondary Hyperparathyroidism

Journal of the American Society of Nephrology ◽

10.1681/asn.v1341017 ◽

2002 ◽

Vol 13 (4) ◽

pp. 1017-1024 ◽

Cited By ~ 1

Author(s):

William G. Goodman ◽

Gerald A. Hladik ◽

Stewart A. Turner ◽

Peter W. Blaisdell ◽

David A. Goodkin ◽

...

Keyword(s):

Parathyroid Hormone ◽

Renal Disease ◽

Secondary Hyperparathyroidism ◽

End Stage Renal Disease ◽

Mineral Metabolism ◽

Hemodialysis Patients ◽

Calcimimetic Agents ◽

Calcium Phosphorus ◽

Stage Renal Disease ◽

End Stage

ABSTRACT. Treatment with vitamin D sterols can lower plasma parathyroid hormone (PTH) in many patients with secondary hyperparathyroidism due to end-stage renal disease, but hypercalcemia, hyperphosphatemia, or both often develop during treatment. As such, alternative therapeutic approaches to managing excess PTH secretion are needed. Calcimimetic agents directly inhibit PTH secretion by activating the calcium-sensing receptor in the parathyroid glands, but clinical experience with them is limited. Fifty-two hemodialysis patients with secondary hyperparathyroidism were given single orally administered doses of the calcimimetic agent AMG 073 ranging from 5 to 100 mg, or placebo. Plasma PTH levels decreased 2 h after 25-, 50-, 75-, or 100-mg doses, falling by a maximum of 43 ± 29%, 40 ± 36%, 54 ± 28%, or 55 ± 39%, respectively. Plasma PTH levels decreased in all patients given doses of ≥25 mg but did not change in those who received placebo. In patients treated with daily doses of 25 or 50 mg of AMG 073 for 8 d, plasma PTH levels declined for the first 3 to 4 d and remained below baseline values after 8 d of treatment. Serum calcium concentrations also decreased by 5 to 10% from pretreatment levels in patients given 50 mg of AMG 073 for 8 d, but values were unchanged in those who received lower doses. Serum phosphorus levels and values for the calcium-phosphorus ion product both decreased after treatment with AMG 073. Thus, 8 d of treatment with AMG 073 effectively lowers plasma PTH levels and improves several disturbances in mineral metabolism that have been associated with soft tissue and vascular calcification and with adverse cardiovascular outcomes in patients with end-stage renal disease.

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POS-546 ONE-YEAR SURVIVAL AMONG END-STAGE RENAL DISEASE PATIENTS ON HEMODIALYSIS IN A SUB-SAHARAN AFRICAN COUNTRY, TANZANIA: A TERTIARY-HOSPITAL RETROSPECTIVE STUDY

Kidney International Reports ◽

10.1016/j.ekir.2021.03.574 ◽

2021 ◽

Vol 6 (4) ◽

pp. S239

Author(s):

J. SWAI

Keyword(s):

Retrospective Study ◽

Renal Disease ◽

End Stage Renal Disease ◽

African Country ◽

Tertiary Hospital ◽

Sub Saharan ◽

One Year ◽

Stage Renal Disease ◽

End Stage

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Real-world evidence and optimization of vocal dysfunction in end-stage renal disease patients with secondary hyperparathyroidism

Scientific Reports ◽

10.1038/s41598-020-79810-0 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Geng-He Chang ◽

Fong-Fu Chou ◽

Ming-Shao Tsai ◽

Yao-Te Tsai ◽

Ming-Yu Yang ◽

...

Keyword(s):

Renal Disease ◽

Secondary Hyperparathyroidism ◽

Real World ◽

End Stage Renal Disease ◽

Cox Regression ◽

Electrolyte Imbalance ◽

Research Database ◽

Cox Regression Analysis ◽

Stage Renal Disease ◽

End Stage

AbstractPatients with end-stage renal disease (ESRD) may demonstrate secondary hyperparathyroidism (SHPT), characterized by parathyroid hormone oversecretion in response to electrolyte imbalance (e.g., hypocalcemia and hyperphosphatemia). Moreover, this electrolyte imbalance may affect vocal cord muscle contraction and lead to voice change. Here, we explored the effects of SHPT on the voices of patients with ESRD. We used data of 147,026 patients with ESRD from the registry for catastrophic illness patients, a sub-database of Taiwan National Health Insurance Research Database. We divided these patients into 2 groups based on whether they had hyperparathyroidism (HPT) and compared vocal dysfunction (VD) incidence among them. We also prospectively included 60 ESRD patients with SHPT; 45 of them underwent parathyroidectomy. Preoperatively and postoperatively, voice analysis was used to investigate changes in vocal parameters. In the real-world database analysis, the presence of HPT significantly increased VD incidence in patients with ESRD (p = 0.003): Cox regression analysis results indicated that patients with ESRD had an approximately 1.6-fold increased VD risk (p = 0.003). In the clinical analysis, the “jitter” and “shimmer” factors improved significantly after operation, whereas the aerodynamic factors remained unchanged. In conclusion, SHPT was an independent risk factor for VD in patients with ESRD, mainly affecting their acoustic factors.

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