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The treatment of re...
The treatment of renal hyperparathyroidism
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- Almquist, Martin (author)
- Lund University,Lunds universitet,Endokrin- och sarkomkirurgi,Forskargrupper vid Lunds universitet,Endocrine and Sarcoma Surgery,Lund University Research Groups,Skåne University Hospital
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- Isaksson, Elin (author)
- Lund University,Lunds universitet,Urologi - blåscancer, Malmö,Forskargrupper vid Lunds universitet,Urology - urothelial cancer, Malmö,Lund University Research Groups,Skåne University Hospital
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- Clyne, Naomi (author)
- Lund University,Lunds universitet,Njurmedicin,Sektion II,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Nephrology,Section II,Department of Clinical Sciences, Lund,Faculty of Medicine,Skåne University Hospital
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(creator_code:org_t)
- 2020
- 2020
- English.
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In: Endocrine-Related Cancer. - 1351-0088. ; 27:1, s. 21-34
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Abstract
Subject headings
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- Renal hyperparathyroidism (rHPT) is a complex and challenging disorder. It develops early in the course of renal failure and is associated with increased risks of fractures, cardiovascular disease and death. It is treated medically, but when medical therapy cannot control the hyperparathyroidism, surgical parathyroidectomy is an option. In this review, we summarize the pathophysiology, diagnosis, and medical treatment; we describe the effects of renal transplantation; and discuss the indications and strategies in parathyroidectomy for rHPT. Renal hyperparathyroidism develops early in renal failure, mainly as a consequence of lower levels of vitamin D, hypocalcemia, diminished excretion of phosphate and inability to activate vitamin D. Treatment consists of supplying vitamin D and reducing phosphate intake. In later stages calcimimetics might be added. RHPT refractory to medical treatment can be managed surgically with parathyroidectomy. Risks of surgery are small but not negligible. Parathyroidectomy should likely not be too radical, especially if the patient is a candidate for future renal transplantation. Subtotal or total parathyroidectomy with autotransplantation are recognized surgical options. Renal transplantation improves rHPT but does not cure it.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Urologi och njurmedicin (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Urology and Nephrology (hsv//eng)
Keyword
- Chronic kidney disease
- Hyperparathyroidism
- Parathyroid hormone
- Parathyroidectomy
- Vitamin D
Publication and Content Type
- for (subject category)
- ref (subject category)
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