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Surgical management of secondary hyperparathyroidism.

Publication ,  Journal Article
Olson, JA; Leight, GS
Published in: Adv Ren Replace Ther
July 2002

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.

Duke Scholars

Published In

Adv Ren Replace Ther

DOI

ISSN

1073-4449

Publication Date

July 2002

Volume

9

Issue

3

Start / End Page

209 / 218

Location

United States

Related Subject Headings

  • Urology & Nephrology
  • Parathyroidectomy
  • Kidney Failure, Chronic
  • Hyperparathyroidism, Secondary
  • Humans
  • Chronic Kidney Disease-Mineral and Bone Disorder
  • 3202 Clinical sciences
  • 1103 Clinical Sciences
 

Citation

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Olson, J. A., & Leight, G. S. (2002). Surgical management of secondary hyperparathyroidism. Adv Ren Replace Ther, 9(3), 209–218. https://doi.org/10.1053/jarr.2002.34840
Olson, John A., and George S. Leight. “Surgical management of secondary hyperparathyroidism.Adv Ren Replace Ther 9, no. 3 (July 2002): 209–18. https://doi.org/10.1053/jarr.2002.34840.
Olson JA, Leight GS. Surgical management of secondary hyperparathyroidism. Adv Ren Replace Ther. 2002 Jul;9(3):209–18.
Olson, John A., and George S. Leight. “Surgical management of secondary hyperparathyroidism.Adv Ren Replace Ther, vol. 9, no. 3, July 2002, pp. 209–18. Pubmed, doi:10.1053/jarr.2002.34840.
Olson JA, Leight GS. Surgical management of secondary hyperparathyroidism. Adv Ren Replace Ther. 2002 Jul;9(3):209–218.
Journal cover image

Published In

Adv Ren Replace Ther

DOI

ISSN

1073-4449

Publication Date

July 2002

Volume

9

Issue

3

Start / End Page

209 / 218

Location

United States

Related Subject Headings

  • Urology & Nephrology
  • Parathyroidectomy
  • Kidney Failure, Chronic
  • Hyperparathyroidism, Secondary
  • Humans
  • Chronic Kidney Disease-Mineral and Bone Disorder
  • 3202 Clinical sciences
  • 1103 Clinical Sciences