Surgical management of secondary hyperparathyroidism.

Journal Article (Journal Article;Review)

Most patients with renal failure maintained on chronic dialysis have elevated parathyroid hormone (PTH) levels and PTH-mediated bone disease (secondary hyperparathyroidism [sHPT]). Elevated PTH production in this setting represents a progressive, exaggerated physiologic response to hypocalcemia by the parathyroid glands, and generalized growth of the parathyroids is an adaptive response to chronic stimulation. Effective medical strategies to reduce PTH secretion and PTH-mediated bone turnover in sHPT (eg, controlling hyperphosphatemia, normalizing serum calcium, and administering vitamin D analogs) has decreased the need for parathyroidectomy in recent years. However, failure of medical therapy because of inadequate treatment, persistent hyperphosphatemia, or acquired parathyroid neoplasia still leads to recommendations for parathyroidectomy in select patients. Furthermore, increased awareness of potential long-term, irreversible cardiovascular effects of uncorrected hyperparathyroidism has led some to advocate parathyroidectomy earlier in the course of this disease. This monograph will review parathyroidectomy for secondary and tertiary hyperparathyroidism.

Full Text

Duke Authors

Cited Authors

  • Olson, JA; Leight, GS

Published Date

  • July 2002

Published In

Volume / Issue

  • 9 / 3

Start / End Page

  • 209 - 218

PubMed ID

  • 12203203

International Standard Serial Number (ISSN)

  • 1073-4449

Digital Object Identifier (DOI)

  • 10.1053/jarr.2002.34840


  • eng

Conference Location

  • United States