Surgical Treatment In Renal Secondary Hyperparathyroidism, A Study Of Nine Cases And Review Of Literatures

Background Chronic kidney disease is rarely reversible and leads to progressive decline in renal function.When progressed to end-stage renal disease(ESRD),blood purification and kidney transplantation are alternatives.Since the initiation of maintenance dialysis.the lives of patients with CRF have been prolonged. While.on the other hand.secondary hyperparathyroidism(SHPT) develops as a result of the metabolic alterations occurring in CRF.Severe complications of intractable SHPT will influence the qualities of CRF patients' lives,even increase the mortality.Objective To evaluate the effect of total parathyroidectomy with forearm autotransplantation in patients of renal secondary huperparathyroidism.Methods The data was retrospectively collected from the 9 patients of The First Affiliated Hospital of Zhejiang University from Oct.2009 to Mar.2011.whom underwent the procedure.To analyze the changes of intact parathyroid hormone(iPTH).blood calcium and phosphate on the 9cases.To compare the numbers of parathyroid glands tested by ultrasound and 99mTc-MIBI with those resected in the operations.Results All patients get a notable fall in recent days after surgery for serum iPTH,Ca2+ and P.B-ultrasonic shows the sensitivity of 65.63% for detecting parathyroid nodes while 99mTc-MIBI shows 30.77%.Conclusion 1.We concluded that total parathyroidectomy with forearm autotransplantation is effective to treat renal SHPT not suppressible by pharmacologic means in recent days after surgery.2.B-ultrasonic is a feasible way to localize parathyroid nodes before surgery.