PARATHYROIDECTOMY IN PATIENTS WITH CHRONIC-RENAL-FAILURE

BACKGROUND: Hyperparathyroidism is common in patients with renal disea se. these patients may require operation for this disease if it cannot be controlled by medical therapy. Because these patients continue to have renal failure, the risk of recurrence and reoperation is high. ME THODS: Sixty-nine patients with renal failure underwent operation for hyperparathyroidism. These patients were followed up on dialysis or af ter transplantation. RESULTS: Sixty-nine patients, aged 2 to 71 years old, with end-stage renal disease required parathyroidectomy for hyper parathyroidism 6.2 +/- 4.2 (standard deviation) years after beginning dialysis. Thirty-six patients had undergone renal transplantation (cre atinine = 1.6 +/- 0.4 mg/dL). All patients had elevated parathyroid ho rmone (PTH) levels. Sixty-eight patients had hyperplasia; 1 patient ha d adenoma. Six patients required reoperation for recurrent hyperparath yroidism 30 to 123 months after their initial parathyroidectomy, CONCL USION: patients with end-stage renal disease are prone to abnormalitie s of calcium metabolism, They frequently develop parathyroid hyperplas ia. Recurrence can occur following operation because of continuing ren al failure. (C) 1998 by Excerpta Medica, Inc.