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Therapie des sekundären renalen Hyperparathyreoidismus – aktueller Stellenwert der Parathyreoidektomie

Management of secondary hyperparathyroidism—current impact of parathyroidectomy

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Zusammenfassung

Die Parathyreoidektomie stellt auch heute noch ein adäquates und effizientes Verfahren zur Therapie des therapierefraktären sekundären Hyperparathyreoidismus (sHPT) dar. Sie ermöglicht abhängig vom angewandten Operationsverfahren die höchste „laborchemische Heilungsrate“ des sHPT. Ob sich diese Verbesserungen auch in einem klinischen Langzeitnutzen hinsichtlich der mit dem sHPT einhergehenden Gefäßverkalkung und erhöhten Risiko für kardiovaskuläre Morbidität und Mortalität sowie Gesamtsterblichkeit niederschlägt, ist offen. Rezente Beobachtungs- und Registerstudien weisen in diese Richtung, der eindeutige Beweis durch prospektive randomisierte kontrollierte Studien steht aber noch aus.

Summary

Parathyroidectomy still presents an adequate and efficient therapeutic option for the management of refractory secondary hyperparathyroidism (sHPT). Dependent on the selected surgical technique it allows the highest rate of “laboratory cure” of sHPT. The question remains as to whether these improvements translate into clinical long-term benefits regarding the sHPT-associated vascular calcification and the increased risk for cardiovascular morbidity and mortality as well as overall mortality. Recent large observational studies point in this direction but definite evidence through prospective randomized controlled trials is still lacking.

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Authors and Affiliations

  1. Abteilung für Nephrologie und Dialyse, Akademisches Lehrkrankenhaus LKH Feldkirch, Carinagasse 47, 6800, Feldkirch, Österreich

    Emanuel Zitt &  Karl Lhotta

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  1. Emanuel Zitt
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  2. Karl Lhotta
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Correspondence to Emanuel Zitt.

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Die Autoren haben Referentenhonorare und Reisekostenzuschüsse für Kongressbesuche von der Fa. AMGEN (Hersteller des Kalzimimetikums Cinacalcet) erhalten.

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Zitt, E., Lhotta, K. Therapie des sekundären renalen Hyperparathyreoidismus – aktueller Stellenwert der Parathyreoidektomie. Wien Med Wochenschr 166, 254–258 (2016). https://doi.org/10.1007/s10354-016-0444-3

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  • DOI: https://doi.org/10.1007/s10354-016-0444-3

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