Targeted surgical parathyroidectomy in end-stage renal disease patients and long-term metabolic control: A single-center experience in the current era
| Autor: | Tibor Fülöp, Mehrdad Hamrahian, Christian A. Koch, Abdeen R. Farah Musa, Kamel A. Gharaibeh, Karen T. Pitman, Mehul Dixit, Zsolt Lengvársky, Christopher Clark |
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| Rok vydání: | 2018 |
| Předmět: |
Parathyroidectomy
Hyperparathyroidism medicine.medical_specialty Cinacalcet business.industry medicine.medical_treatment 030232 urology & nephrology Urology Parathyroid hormone Hematology medicine.disease Single Center End stage renal disease 03 medical and health sciences 0302 clinical medicine Nephrology medicine Secondary hyperparathyroidism 030212 general & internal medicine Hemodialysis business medicine.drug |
| Zdroj: | Hemodialysis International. 22:394-404 |
| ISSN: | 1492-7535 |
| Popis: | BACKGROUND The long-term results of surgical parathyroidectomy (PTX) in end-stage renal disease (ESRD) patients are less well known in the modern era of newer activated vitamin-D analogs, calcimimetics and intraoperative monitoring of parathyroid hormone (PTH). METHODS We performed a retrospective chart review of all ESRD patients undergoing PTX at the University of Mississippi Medical Center between January 2005 and August 2011, with follow-up data as available up to 4 years. All PTXs were performed with intraoperative second-generation PTH monitoring and targeted gland size reduction. RESULTS The cohort (N = 37) was relatively young with a mean (±SD) age of 48.4 ± 13.9. 94.6% of the subjects were African American and 59.5% female. Preoperatively, 45.9% received cinacalcet (CNC) at a mean dose of 63.5 ± 20.9 mg. The size of the largest removed glands measured 1.7 ± 0.8 cm and almost all (94.6%) glands had hyperplasia on histology. The mean length of inpatient stay was 5.5 ± 2.4 days. Preoperative calcium/phosphorus measured 9.6 ± 1.2/6.6 ± 1.7 mg/dL with PTH concentrations of 1589 ± 827 pg/mL. Postoperative PTH values measured 145.4 ± 119.2 pg/mL. Preoperative PTH strongly correlated (P |
| Databáze: | OpenAIRE |
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