[Experience in using teriparatide for the treatment of postoperative hypoparathyroidism in hemodialysis patients]

Abstract

The frequency of chronic postoperative hypoparathyroidism after total parathyroidectomy for secondary and tertiary hyperparathyroidism in patients with end-stage renal failure, according to various authors, can reach 20% or more. Prescribing active metabolites of vitamin D and calcium it is not always sufficient for achievement of target goals. This dictates the need for replacement therapy with recombinant parathyroid hormone. Teriparatide is the only drug of this series approved by the American Food and Drug Administration (FDA) and registered in the Russian Federation. However, it is registered as an anabolic anti-osteoporotic drug and is not indicated for the treatment of chronic hypoparathyroidism. The use of teriparatide in postoperative hypoparathyroidism in patients receiving renal replacement therapy with programmed hemodialysis in the Russian Federation has not been previously studied. Data on this issue is also limited in foreign literature. However, it is a potential treatment option for hemodialysis patients with chronic hypoparathyroidism and severe bone disorders. In this article, we present 2 clinical cases of substitution and anabolic therapy with teriparatide in this cohort of patients.

Рисунок 1. Рентгенография позвоночника пациентки В.: грудного (А) и поясничного (В) отделов в боковой проекции. Пояснения в тексте.Figure 1. X-ray of patient В’s spine: thoracic (A) and lumbar (B) sections in lateral view. Explanations in the text.

Рисунок 2. Рентгенография позвоночника пациентки А.: грудной (А, C, E) и поясничный (В, D, F) отделы в боковых проекциях. А и В — июль 2018 г., C и D — сентябрь 2019 г., Е и F — сентябрь 2020 г. Пояснения в тексте.Figure 2. X-ray of patient A’s spine: thoracic (A, C, E) and lumbar (B, D, F) sections in lateral views. A and B — July 2018, C and D — September 2019, E and F — September 2020. Explanations in the text.