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Revista médica de Chile

versión impresa ISSN 0034-9887

Resumen

PULGAR B, Dahiana; JARA C, Aquiles; GONZALEZ V, Gilberto  y  GONZALEZ D, Hernán. Surgical treatment of renal hyperparathyroidism. Experience in 71 patients . Rev. méd. Chile [online]. 2015, vol.143, n.2, pp.190-196. ISSN 0034-9887.  http://dx.doi.org/10.4067/S0034-98872015000200006.

Background: Surgery is an effective method for the management of renal hyperparathyroidism. Aim: To report the clinical presentation and results of surgical treatment of renal hyperparathyroidism. Material and Methods: Retrospective analysis of 58 patients aged 46 ± 11 years with secondary hyperparathyroidism (HPT2) and 13 patients aged 53 ± 11 years with tertiary hyperparathyroidism (HPT3), operated at a clinical hospital. Results: In 55 cases (77.4%) the indications for surgery were complications of excess parathyroid hormone (PTH) and in 16 patients (22.6%) a failure of medical treatment. Total parathyroidectomy with intraoperative measurement of PTH (PTHop) plus a forearm parathyroid autograft was performed in 54 (93.1%) patients with HPT2 and in all patients with HPT3. PTHop decreased ≥ 75% in 51 patients (88%) with HPT2 and in 9 patients (69.2%) with HPT3, respectively. Cure of the disease was achieved in 52 (89.7%) and 11 (84.6%) patients with HPT2 and 3, respectively. Median follow-up was 41 months. Five (9.6%) patients with HPT2 and two patients (18.2%) with HPT3 had a recurrence of the disease. Conclusions: In patients with renal hyperparathyroidism, the primary indication for surgery was the presence of complications of PTH excess. A drop in PTHop ≥ 75% from baseline predicts healing in 98% and 100% of cases with secondary or tertiary HPT respectively. Surgery was a safe and effective treatment in both groups.

Palabras clave : Hyperparathyroidism, secondary; Parathyroid hormone; Surgery.

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