Wiener Medizinische Wochenschrift

, Volume 166, Issue 7–8, pp 254–258 | Cite as

Therapie des sekundären renalen Hyperparathyreoidismus – aktueller Stellenwert der Parathyreoidektomie

übersicht

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.

Schlüsselwörter

Dialyse Sekundärer Hyperparathyreoidismus Parathyreoidektomie 

Management of secondary hyperparathyroidism—current impact of parathyroidectomy

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.

Keywords

Dialysis Secondary hyperparathyroidism Parathyroidectomy 

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Copyright information

© Springer-Verlag Wien 2016

Authors and Affiliations

  1. 1.Abteilung für Nephrologie und DialyseAkademisches Lehrkrankenhaus LKH FeldkirchFeldkirchÖsterreich

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