#PAGE_PARAMS# #ADS_HEAD_SCRIPTS# #MICRODATA#

Dysfunction of Parathyroids in Patients on Regular Dialysis Treatmentand after Kidney Transplantation


Authors: I. Sotorník;  P. Bubeníček;  M. Adamec 1;  L. Karasová 2;  C. Povýšil 4;  J. Skibová 3
Authors‘ workplace: Klinika nefrologie IKEM, Praha 1Klinika transplantační chirurgie IKEM, Praha 2Laboratoř metabolických metod IKEM, Praha 3Pracoviště lékařské statistiky IKEM, Praha 4Patologicko-anatomický ústav 1. LF UK, Praha
Published in: Čas. Lék. čes. 2003; : 229-234
Category:

Overview

Background.
Parathyroids dysfunction is a key disorder in the spectrum of renal osteopathy, occurring after renaltransplantation and, occasionally, after parathyroidectomy. In our subjects, dysfunction is understood as plus orminus activity.Methods and Results. Parathyroidectomy as the primary procedure was performed in 179 patients for all types ofhyperparathyrodism. In 70 % of cases the secondary hyperparathyroidism was treated, believed to be the most severecondition. Present assessment was focused on postoperative parathyroid hormone levels (pg/ml) in three groups ofpatients (n=92). Group 1 with parathyroid gland autoimplants following total parathyroidectomy; Group 2 afterpartial or subtotal surgery; Group 3 after autologous implantation of cryopreserved parathyroid glands in severehypoparathyroidism. Group 1 (32 dialysis and 9 non-dialysed patients): 228.9 vs 85.9 pg/ml; ns; hypofunction in50 % and in 33 % respectively, afunction in 12.5 % of dialysed patients, in non-dialysed patients it was not detected.Group 2 (25 dialysis and 24 non-dialysed patients): 603.3 vs 169.8 (pg/ml); p=0.01; hypofunction in 16 % and in8% respectively, afunction was not detected. Complete groups 1 and 2 of patients: 197.5 vs 382.3 pg/ml (p=0.0016).Dialysed patients in Group 1 and 2: 228.9 vs 603.3 pg/ml (p=0.007); non-dialysed patients: 85.9 vs 169.8 pg/ml; ns.Group 3 (15 dialysed patients): 63.0; hypofunction and afunction in 40 %. This group (63,0 pg/ml) vs Groups 1 and2 of dialysed patients (p=0.031 and 0.0004), respectively. Basic laboratory findings before operations of tertiaryhyperparathyroidism were shown.Conclusions. After total parathyroidectomy with parathyroids autoimplantation, parathyroid hormone is acceptableto dialysis and non-dialysis patients. Partial parathyroidectomy prevents development of hypoparathyroidism. It isassociated, however, with a risk because of hyperparathyrodism recurrence. Cryopreserved autologous parathyroidsreach lower parathyroid levels compared with „fresh“ parathyroid tissue autoimplants. Parathyroidectomy aftersuccessful renal transplantation may be inicated.

Key words:
parathyroid hormone, hyperparathyroidism, hemodialysis, renal transplantation, parathyroidectomy,hypoparathyroidism, parathyroid gland implantations.

Full text is not available online.
If interested in a scan of this journal, contact NTO ČLS JEP.

Labels
Addictology Allergology and clinical immunology Angiology Audiology Clinical biochemistry Dermatology & STDs Paediatric gastroenterology Paediatric surgery Paediatric cardiology Paediatric neurology Paediatric ENT Paediatric psychiatry Paediatric rheumatology Diabetology Pharmacy Vascular surgery Pain management Dental Hygienist

Article was published in

Journal of Czech Physicians


Most read in this issue
Topics Journals
Login
Forgotten password

Enter the email address that you registered with. We will send you instructions on how to set a new password.

Login

Don‘t have an account?  Create new account

#ADS_BOTTOM_SCRIPTS#