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Secondary Hyperparathyroidism: Surgical

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Handbook of Parathyroid Diseases

Abstract

The most common cause of refractory secondary hyperparathyroidism (2HPT) requiring surgical intervention is end-stage renal disease (ESRD) requiring dialysis. Renal insufficiency gradually results in low serum calcium and high phosphate levels. These factors often in association with vitamin D deficiency stimulate parathyroid hormone (PTH) production thereby resulting in progressive hypercalcemia. Medical management, such as Vitamin D therapy, has improved 2HPT for patients with ESRD and most patients do not require parathyroid surgery [1–5]. However, it is estimated that currently almost 1% of patients on dialysis per year and up to 15% of dialysis patients at 10 years will require parathyroidectomy [6–8] due to rising levels of PTH as the parathyroid glands become hyperplasic and eventually autonomous [9]. Other causes of 2HPT include malabsorption or rarer conditions, such as congenital hypophosphatemic osteomalacia, but these rarely cause hypercalcemia requiring surgery.

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Authors and Affiliations

  1. Department of Otolaryngology-Head and Neck Surgery, University of Western Ontario, London, ON, Canada

    John Yoo MD, FRCS(C), FACS

  2. Department of Surgery, McMaster University, Hamilton, ON, Canada

    J. E. M. Young BSc, MD, FRCS, FACS

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  1. John Yoo MD, FRCS(C), FACS
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  2. J. E. M. Young BSc, MD, FRCS, FACS
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Correspondence to John Yoo MD, FRCS(C), FACS .

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Editors and Affiliations

  1. , Dept of Endocrinology and Metabolism, McMaster University, [not given], Hamilton, L8S4L8, Ontario, Canada

    Aliya A. Khan, MD

  2. Mt. Zion Medical Center, Dept. Surgery, University of California, San Francisco, Divisadero St. 1600, San Francisco, 94115, California, USA

    Orlo H. Clark

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Yoo, J., Young, J.E.M. (2012). Secondary Hyperparathyroidism: Surgical. In: Khan, MD, A., Clark, O. (eds) Handbook of Parathyroid Diseases. Springer, Boston, MA. https://doi.org/10.1007/978-1-4614-2164-1_10

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