Cinacalcet versus Parathyroidectomy in the Treatment of Secondary Hyperparathyroidism Post Renal Transplantation
| Autor: | Hoda Abdel Hamid Maamoun, Hatem Darwish, Mahmoud A. Soliman, Esam Elbanna, Amin R. Soliman |
|---|---|
| Rok vydání: | 2016 |
| Předmět: |
Parathyroidectomy
cinacalcet hydrochloride Adult Male medicine.medical_specialty Cinacalcet endocrine system diseases Adolescent Calcimimetic medicine.medical_treatment 030232 urology & nephrology Urology 030230 surgery Calcimimetic Agents Subtotal Parathyroidectomy hyperparathyroidism 03 medical and health sciences Young Adult 0302 clinical medicine Postoperative Complications Internal medicine medicine Humans Hyperparathyroidism business.industry Standard treatment Middle Aged medicine.disease RC31-1245 Kidney Transplantation Transplantation surgical procedures operative Secondary hyperparathyroidism Female Hyperparathyroidism Secondary business medicine.drug |
| Zdroj: | Romanian Journal of Internal Medicine, Vol 54, Iss 3, Pp 184-189 (2016) |
| ISSN: | 1220-4749 |
| Popis: | Background. Persistent hyperparathyroidism (HPT) with hypercalcemia is prevalent after transplant and is considered a risk factor for progressive bone loss and fractures and vascular calcification, as well as the development of tubulointerstitial calcifications of renal allografts and graft dysfunction. The subtotal parathyroidectomy is the standard treatment, although currently it has been replaced by the calcimimetic cinacalcet. Aim. The hypothesis of this study is that subtotal parathyroidectomy is superior to cinacalcet for treatment of persistent secondary parathyroidectomy post renal transplant, with minimal morbidity and significantly it reduces the cost of treatment after transplantation. Methods. We report our long-term clinical experience with either cinacalcet or parathyroidectomy in 59 kidney transplant recipients with hyperparathyroidism. Group one included medical treatment with cinacalcet and had 45 patients while parathyroidectomy patients (group 2) were 16 patients with two of them excluded because of surgical failure. Results. No difference was found between groups for any parameter. A greater short-term change of calcium and phosphorus homeostasis obtained by surgery than by cinacalcet, and in long term change, no significant difference between the two groups. Conclusions: The main findings of this study are that correction of severe hyperparathyroidism was similar in both surgical and cinacalcet groups with the absence of a difference of long-term serum iPTH 1-84 levels between the two groups. |
| Databáze: | OpenAIRE |
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