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Journal of Bone and Mineral Metabolism

, Volume 9, Issue 3, pp 56–62 | Cite as

Surgical treatment of secondary hyperparathyroidism

  • Yoshihiro Tominaga
  • Yuji Tanaka
  • Keisuke Sato
  • Masahiro Numano
  • Kazuharu Uchida
  • Hiroshi Takagi
Workshop On PTH And Renal Osteodystorophy July 14, 1990 Hotel Paciffic Meridian Tokyo, Japan

Abstract

Secondary hyperparathyroidism is one of the most serious complications for long-term hemodialysis patients. In our department, we performed parathyroidectomies on 215 patients between July 1973 and June 1990. We found that parathyroidectomies on 215 patients between July 1973 and June 1990. We found that parathyroidectomy was an effective treatment for advanced renal hyperparathyroidism and that after total parathyroidectomy with forearm autograft, renal hyperparathyroidism was controllable, even when hyperparathyroidism was progressive. However, the timing of this operation was important, because skeletal deformity and vessel calcification did not improve after parathyroidectomy. There were two problems after parathyroidectomy for secondary hyperparathyroidism. One was persistent hyperparathyroidism due to supernumerary parathyroid glands, particularly those located in the mediastinum, and the other was recurrent hyperparathyroidism. From our clinical and pathohistological investigations, we suspected that the proliferation of parathyroid cells changed with the progress of renal hyperparathyroidism and we found that it was difficult to prevent enlargement of parathyroid glands and recurrence of this problem.

Key Words

Secondary hyperparathyroidism Chronic renal failure Parathyroidectomy Persistent hyperparathyroidism Recurrent hyperparathyroidism 

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Copyright information

© Japanese Society of Bone Metabolism Research 1991

Authors and Affiliations

  • Yoshihiro Tominaga
    • 1
  • Yuji Tanaka
    • 2
  • Keisuke Sato
    • 1
  • Masahiro Numano
    • 1
  • Kazuharu Uchida
    • 1
  • Hiroshi Takagi
    • 2
  1. 1.Department of Transplant SurgeryNagoya 2nd Red Cross HospitalNagoyaJapan
  2. 2.Department of Surgery IINagoya University School of MedicineJapan

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