Abstract
Tertiary hyperparathyroidism is hypercalcemia after kidney transplantation. A near-total parathyroidectomy is curative for tertiary hyperparathyroidism and should be considered within the first year of kidney transplantation if hypercalcemia does not resolve. Cure rates of hypercalcemia after a parathyroidectomy for tertiary hyperparathyroidism are >95%.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Apaydin S, Sariyar M, Erek E, Ataman R, Yiğitbaş R, Hamzaoğlu I, Serdengeçti K, Ulkü U. Hypercalcemia and hyperparathyroidism after renal transplantation. Nephron. 1999;81(3):364–5.
Evenepoel P, Claes K, Kuypers D, Maes B, Bammens B, Vanrenterghem Y. Natural history of parathyroid function and calcium metabolism after kidney transplantation: a single-centre study. Nephrol Dial Transplant. 2004;19(5):1281–7.
Triponez F, Clark OH, Vanrenthergem Y, Evenepoel P. Surgical treatment of persistent hyperparathyroidism after renal transplantation. Ann Surg. 2008;248(1):18–30. https://doi.org/10.1097/SLA.0b013e3181728a2d.
Gwinner W, Suppa S, Mengel M, Hoy L, Kreipe HH, Haller H, Schwarz A. Early calcification of renal allografts detected by protocol biopsies: causes and clinical implications. Am J Transplant. 2005;5(8):1934–41.
D’Alessandro AM, Melzer JS, Pirsch JD, Sollinger HW, Kalayoglu M, Vernon WB, Belzer FO, Starling JR. Tertiary hyperparathyroidism after renal transplantation: operative indications. Surgery. 1989;106(6):1049–55. discussion 1055–6.
Kandil E, Florman S, Alabbas H, Abdullah O, McGee J, Noureldine S, Slakey D, Zhang R. Exploring the effect of parathyroidectomy for tertiary hyperparathyroidism after kidney transplantation. Am J Med Sci. 2010;339(5):420–4. https://doi.org/10.1097/MAJ.0b013e3181d8b6ff.
Kinnaert P, Nagy N, Decoster-Gervy C, De Pauw L, Salmon I, Vereerstraeten P. Persistent hyperparathyroidism requiring surgical treatment after kidney transplantation. World J Surg. 2000;24(11):1391–5.
Kerby JD, Rue LW, Blair H, Hudson S, Sellers MT, Diethelm AG. Operative treatment of tertiary hyperparathyroidism: a single-center experience. Ann Surg. 1998;227(6):878–86.
Evenepoel P, Claes K, Kuypers DR, Debruyne F, Vanrenterghem Y. Parathyroidectomy after successful kidney transplantation: a single Centre study. Nephrol Dial Transplant. 2007;22(6):1730–7.
Rix M, Lewin E, Olgaard K. Posttransplant bone disease. Transplant Rev. 2003;17:176–86.
Pitt SC, Sippel RS, Chen H. Secondary and tertiary hyperparathyroidism, state of the art surgical management. Surg Clin North Am. 2009;89(5):1227–39. https://doi.org/10.1016/j.suc.2009.06.011.
Schwarz A, Rustien G, Merkel S, et al. Decreased renal transplant function after parathyroidectomy. Nephrol Dial Transplant. 2007;22:584–91.
Madorin C, Owen RP, Fraser WD, Pellitteri PK, Radbill B, Rinaldo A, Seethala RR, Shaha AR, Silver CE, Suh MY, Weinstein B, Ferlito A. The surgical management of renal hyperparathyroidism. Eur Arch Otorhinolaryngol. 2012;269(6):1565–76. https://doi.org/10.1007/s00405-011-1833-2.
Sharma J, Raggi P, Kutner N, Bailey J, Zhang R, Huang Y, Herzog CA, Weber C. Improved long-term survival of dialysis patients after near-total parathyroidectomy. J Am Coll Surg. 2012;214(4):400–7 discussion 407–8. https://doi.org/10.1016/j.jamcollsurg.2011.12.046.
Heyliger A, Tangpricha V, Weber C, Sharma J. Parathyroidectomy decreases systolic and diastolic blood pressure in hypertensive patients with primary hyperparathyroidism. Surgery. 2009;146(6):1042–7. https://doi.org/10.1016/j.surg.2009.09.024.
Milas M, Weber CJ. Near-total parathyroidectomy is beneficial for patients with secondary and tertiary hyperparathyroidism. Surgery. 2004;136(6):1252–60.
Daniel WT, Weber C, Bailey JA, Raggi P, Sharma J. Prospective analysis of coronary calcium in patients on dialysis undergoing a near-total parathyroidectomy. Surgery. 2013;154(6):1315–21 discussion 1321–2. https://doi.org/10.1016/j.surg.2013.06.030.
McPhaul JJ, McIntosh DA, Hammond WS, Park OK. Autonomous secondary (renal) parathyroid hyperplasia. N Engl J Med. 1964;271:1342–5.
Evenepoel P, Van Den Bergh B, Naesens M, De Jonge H, Bammens B, Claes K, Kuypers D, Vanrenterghem Y. Calcium metabolism in the early posttransplantation period. Clin J Am Soc Nephrol. 2009;4(3):665–72. https://doi.org/10.2215/CJN.03920808.
Torres A, Lorenzo V, Salido E. Calcium metabolism and skeletal problems after transplantation. J Am Soc Nephrol. 2002;13(2):551–8.
Sutliff RL, Weber CS, Qian J, Miller ML, Clemens TL, Paul RJ. Vasorelaxant properties of parathyroid hormone-related protein in the mouse: evidence for endothelium involvement independent of nitric oxide formation. Endocrinology. 1999;140(5):2077–83.
Massfelder T, Parekh N, Endlich K, Saussine C, Steinhausen M, Helwig JJ. Effect of intrarenally infused parathyroid hormone-related protein on renal blood flow and glomerular filtration rate in the anaesthetized rate. Br J Pharmacol. 1996;118(8):1995–2000.
Dewberry L, Tata S, Graves S, Weber C, Sharma J. Predictors of tertiary hyperparathyroidism: who will benefit from parathyroidectomy? Surgery. 2014;156:1631–7.
Somnay Y, Weinlander E, Alfhedi A, Schneider D, Sippel R, Chen H. Radioguided parathyroidectomy for tertiary hyperparathyroidism. J Surg Res. 2015;195:406–11.
Hsieh TM, Sun CK, Chen YT, Chou FF. Total parathyroidectomy versus subtotal parathyroidectomy in the treatment of tertiary hyperparathyroidism. Am Surg. 2012;78:600–6.
Park JH, Kang S-W, Jeong JJ, Nam K-H, Chang HS, Chung WY, et al. Surgical treatment of tertiary hyperparathyroidism after renal transplantation: a 31-year experience in a single institution. Endocr J. 2011;58:827–33.
Sadideen HM, Taylor JD, Goldsmith DJ. Total parathyroidectomy without autotransplantation after renal transplantation for tertiary hyperparathyroidism: long-term follow-up. Int Urol Nephrol. 2012;44:275–81.
Schlosser K, Endres N, Celik I, Fendrich V, Rothmund M, Fernández ED. Surgical treatment of tertiary hyperparathyroidism: the choice of procedure matters! World J Surg. 2007;31:1947–53.
Triponez F, Kebebew E, Dosseh D, Duh QY, Hazzan M, Noel C, et al. Less-than-subtotal parathyroidectomy increases the risk of persistent/recurrent hyperparathyroidism after parathyroidectomy in tertiary hyperparathyroidism after renal transplantation. Surgery. 2006;140:990–7.
Yang RL, Freeman K, Reinke CE, Fraker DL, Karakousis GC, Kelz RR, Doyle AM. Tertiary hyperparathyroidism in kidney transplant recipients: characteristics of patients selected for different treatment strategies. Transplantation. 2012;15(94):70–6.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2018 Springer International Publishing AG, part of Springer Nature
About this chapter
Cite this chapter
Sharma, J., Weber, C. (2018). Early Versus Late Parathyroidectomy for Tertiary (Posttransplant) Hyperparathyroidism. In: Angelos, P., Grogan, R. (eds) Difficult Decisions in Endocrine Surgery. Difficult Decisions in Surgery: An Evidence-Based Approach. Springer, Cham. https://doi.org/10.1007/978-3-319-92860-9_18
Download citation
DOI: https://doi.org/10.1007/978-3-319-92860-9_18
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-92858-6
Online ISBN: 978-3-319-92860-9
eBook Packages: MedicineMedicine (R0)