Abstract
Between April 1986 and January 1992, a tota of 22 patients with chronic renal failure were operated on for secondary hyperparathyroidism after kidney trans plantation, and 21 of these patients were normocalcemi, postoperatively. In 1 patient three reductions of auto transplantated parathyroid tissue were performed an this patient was still hypercalcemic postoperatively, with a serum calcium of 2.65 mmol/1. The renal function wa not impaired by parathyroidectomy. In 9 of the 22 patients subtotal parathyroidectomy was indicated within months after renal transplantation because of serum calcium levels over 3.0 mmol/1 or severe clinical symptoms. Subtotal parathyroidectomy is indicated in patients with secondary hyperparathyroidism after renal transplantation with a serum calcium over 3.0 mmol/1 and sever, clinical symptoms and also in patients with slightly elevated serum calcium levels after an observation period of up to 12 months.
Zusammenfassung
Zwischen dem 1.4.1986 und dem 1.1.1992 wurden 22 Patienten mit einem sekundären Hyperparathyreoidismus (HPT) nach Nierentransplantation (NTP) operiert. 21 Patienten waren postoperativ normokalzämisch und 1 Patient zeigte trotz der 3maligen Reduktion des Autotransplantats weiterhin einen Serumkalziumwert von 2,65 mmol/1. In keinem Fall wurde die Nierenfunktion durch die Operation beeinträchtigt. In 9 Fällen wurde die subtotale Parathyreoidektomie (SPTX) innerhalb der ersten 4 Monate nach der NTP notwendig. Die Indikation zur subtotalen Parathyreoidektomie wird bei alien Patienten mit Serumkalziumwerten > 3,0 mmol/1 and schweren klinischen Symptomen sofort gestellt. Bei Serumkalziumwerten < 3,0 mmol/1 kann ein Beobachtungszeitraum von bis zu 12 Monaten ohne akute Gefährdung des Transplantats akzeptiert werden.
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Dotzenrath, C., Goretzki, P.E. & Röher, H.D. Operative therapie des sekundaren hyperparathyreoidismus nach nierentransplantation. Langenbecks Arch Chir 378, 121–124 (1993). https://doi.org/10.1007/BF00202121
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DOI: https://doi.org/10.1007/BF00202121