Secondary hyperparathyroidism status in Brazil: Brazilian census of parathyroidectomy.
| Autor: | Oliveira RB; Comitê de Distúrbio Mineral e Ósseo na Doença Renal Crônica, Sociedade Brasileira de Nefrologia, São Paulo, SP, Brasil. rodrigobueno.hc@gmail.com, Silva EN, Charpinel DM, Gueiros JE, Neves CL, Sampaio Ede A, Barreto Fde C, Karohl C, Ribeiro MC, Moysés RM, Jorgetti V, Carvalho AB |
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| Jazyk: | English; Portuguese |
| Zdroj: | Jornal brasileiro de nefrologia [J Bras Nefrol] 2011 Dec; Vol. 33 (4), pp. 457-62. |
| Abstrakt: | Introduction: Secondary hyperparathyroidism (SHP) is a common and serious complication of chronic kidney disease (CKD), with a negative impact on morbidity and mortality. Despite advances in the clinical management of SHP, treatment failure still occurs in a significant number of patients. In such cases, parathyroidectomy (PTx) is indicated. Objective: To have an overview of the prevalence of severe SHP and of its surgical treatment in hemodialysis (HD) patients in Brazil. Methods: This was an observational and descriptive study. Data were obtained from questionnaires posted to 660 dialysis units (DU). Results: Results are expressed in absolute values and percentages, or means and standard deviation, as appropriate. 226 (34%) DU answered the questionnaire, providing data about 32,264 HD patients. The prevalence rate of severe SHP (PTH > 1,000 pg/mL) was 10.7 % (n = 3,463). 68 hospitals countrywide perform PTX. Around 40% of them are university centers. 49 (21.7%) DU reported not to have a specialized medical center to refer their patients with severe SHP. 74 (33%) DU reported that the time interval between surgery indication and its performance was over 6 months. The main recognized obstacles to surgery performance were: difficulty to perform the preoperative exams, lack of head and neck surgeons and the long waiting time. Conclusions: Although severe SHP is highly prevalent in Brazil, a significant number of patients do not have access to PTx. Better public health policies and liaison between nephrologists and head and neck surgeons are urgently required to change this reality. |
| Databáze: | MEDLINE |
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