scholarly journals Surgical Treatment of Secondary Hyperparathyroidism due to Chronic Kidney Disease

2006 ◽  
Vol 111 (3) ◽  
pp. 277-292 ◽  
Author(s):  
Yoshihiro Tominaga
Keyword(s):  
Chronic Kidney Disease ◽  
Surgical Treatment ◽  
Kidney Disease ◽  
Secondary Hyperparathyroidism

scholarly journals Surgical Treatment of Secondary Hyperparathyroidism at Ectopic Parathyroid Gland in Anterior-Superior Mediastinum (Literature Review and Clinical Case)

2020 ◽  
Vol 5 (4) ◽  
pp. 84-89
Author(s):  
E. A. Ilyicheva ◽  
D. A. Bulgatov ◽  
A. V. Zharkaya ◽  
V. N. Makhutov ◽  
E. G. Grigoryev
Keyword(s):  
Chronic Kidney Disease ◽  
Surgical Treatment ◽  
Kidney Disease ◽  
Secondary Hyperparathyroidism ◽  
Parathyroid Gland ◽  
Clinical Case ◽  
Parathyroid Glands ◽  
Total Parathyroidectomy ◽  
Special Equipment ◽  
Superior Mediastinum

Parathyroidectomy is the leading treatment for drug-refractory secondary and tertiary hyperparathyroidism in patients with chronic kidney disease. Difficulties in performing this surgery are mainly associated with the anatomical features of the parathyroid glands, in particular with the variability of their number and topographic anatomy. Ectopic parathyroid glands are one of the most common causes of persistence or recurrence of secondary hyperparathyroidism after surgery. One of the common variants of ectopia is the localization of the parathyroid gland in the anterior-superior mediastinum. The article discusses the features of surgical treatment of secondary hyperparathyroidism in patients with end-stage chronic kidney disease with this ectopia. A new method of treating hyperparathyroidism in patients with an atypical location of the parathyroid gland in the anterior-superior mediastinum is presented. This method is characterized by low invasiveness of access, ease of implementation without using special equipment and instruments. The proposed method was used in the treatment of a patient with secondary hyperparathyroidism due to chronic renal failure as a result of chronic glomerulonephritis. The duration of hemodialysis at the time of the surgery was more than 17 years. In the presented clinical case, ectopia of one of the pathologically altered parathyroid glands in the anterior-superior mediastinum was found at the preoperative stage. As a method of surgical treatment, we carried out total parathyroidectomy with autotransplantation of a fragment of parathyroid tissue into the brachioradialis muscle. Thanks to this method, it was possible to remove the atypically located parathyroid gland from the cervicotomy access and to discharge the patient within the standard terms for a given volume of surgery.

scholarly journals Persistence of secondary hyperparathyroidism after parathyroidectomy in a patient with chronic kidney disease: a case report

2021 ◽  
Vol 14 (3) ◽  
pp. 19-26
Author(s):  
Elena A. Ilyicheva ◽  
Gleb A. Bersenev ◽  
Dmitry A. Bulgatov ◽  
Valeriy N. Makhutov
Keyword(s):  
Chronic Kidney Disease ◽  
Parathyroid Hormone ◽  
Surgical Treatment ◽  
Kidney Disease ◽  
Secondary Hyperparathyroidism ◽  
Imaging Techniques ◽  
Preoperative Imaging ◽  
Extent Of Surgery ◽  
The Right ◽  
Intraoperative Test

This is a clinical case of surgical treatment of persistence of secondary hyperparathyroidism (SHPT) in a patient with chronic kidney disease after previous parathyroidectomy. Programmed hemodialysis started in 2014, and in 2016 SHPT was diagnosed. In November 2018, indications for surgical treatment were presented in one of the clinics. According to scintigraphy, an increase in the functional activity of all four parathyroid glands (PTG) was observed, according to ultrasound data, the localization of the right lower, left upper and lower PTG was established. Removal of 3x PTG was performed without revision of the thymus horns (11.2018), while in the postoperative period, an adequate decrease in parathyroid hormone was not observed. After additional examination, according to ultrasound, scintigraphy and computer tomography of the neck with intravenous enhancement, it was found that both lower PTGs are located in the upper horns of the thymus. In July 2020, a repeated surgical intervention was performed in the volume of the right lower and left lower parathyroidectomy with a positive intraoperative test. Remission of SHPT was achieved. At present, no consensus has been reached on the extent of surgery for SHPT, since no statistically significant differences were found in the incidence of persistence / recurrence of SHPT. A complete assessment of the results of preoperative imaging techniques is required when planning surgery. Intraoperative monitoring of parathyroid hormone is an effective technique for assessing the radicality of surgical treatment.

Effect of parathyroidectomy on bone tissue biomarkers and body composition in patients with chronic kidney disease and secondary hyperparathyroidism

2021 ◽  
Author(s):  
Flavia Ramos de Siqueira ◽  
Karin Carneiro de Oliveira ◽  
Wagner Vasques Dominguez ◽  
César Augusto Madid Truyts ◽  
Rosa Maria Affonso Moysés ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Body Composition ◽  
Kidney Disease ◽  
Secondary Hyperparathyroidism ◽  
Bone Tissue ◽  
Tissue Biomarkers

Calcifediol to treat secondary hyperparathyroidism in patients with chronic kidney disease

2017 ◽  
Vol 10 (10) ◽  
pp. 1073-1084 ◽  
Author(s):  
Andrea Galassi ◽  
Antonio Bellasi ◽  
Paola Ciceri ◽  
Francesca Pivari ◽  
Ferruccio Conte ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Secondary Hyperparathyroidism
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