[Surgical therapy of secondary hyperparathyroidism after kidney transplantation]

Abstract

Between April 1986 and January 1992, a total of 22 patients with chronic renal failure were operated on for secondary hyperparathyroidism after kidney transplantation, and 21 of these patients were normocalcemic postoperatively. In 1 patient three reductions of autotransplanted parathyroid tissue were performed and this patient was still hypercalcemic postoperatively, with a serum calcium of 2.65 mmol/l. The renal function was not impaired by parathyroidectomy. In 9 of the 22 patients subtotal parathyroidectomy was indicated within 4 months after renal transplantation because of serum calcium levels over 3.0 mmol/l or severe clinical symptoms. Subtotal parathyroidectomy is indicated in patients with secondary hyperparathyroidism after renal transplantation with a serum calcium over 3.0 mmol/l and severe clinical symptoms and also in patients with slightly elevated serum calcium levels after an observation period of up to 12 months.