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Year : 2019  |  Volume : 3  |  Issue : 3  |  Page : 773-779

Parathyroidectomy with and without autografting in management of secondary hyperparathyroidism in hemodialysis patients

Department of Internal Medicine, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt

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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/sjamf.sjamf_102_19

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Background Secondary hyperparathyroidism (sHPT) develops in most, if not all, patients with end-stage renal disease. It is known as long-term parathyroid hyperplasia, which results in the formation of functionally independent parathyroid adenoma. sHPT can lead to high-turnover bone disease, interstitial and vascular calcifications, as well as cardiovascular mortality and morbidity. Objective To study the value of parathyroid autografting following parathyroidectomy in cases of sHPT with chronic renal failure. Patients and methods A total of 30 patients with end-stage renal disease on dialysis with sHPT were enrolled in this study. All patients are subjected to parathyroidectomy (15 patients with autografting vs. 15 patients without autografting). Clinical evaluation and laboratory investigations (including serum intact parathormone, total and ionized calcium, phosphorus, and alkaline phosphatase) were done preoperatively and postoperatively. Results There was a significant difference between preoperative and postoperative clinical and laboratory parameters in both groups. Moreover, there was a significant decrease in hospital and intravenous calcium in the group subjected to autografting. Otherwise, there was a nonsignificant difference between the two groups regarding calcium, phosphorus, intact parathormone, and alkaline phosphatase. Conclusion Parathyroid autografting following parathyroidectomy in patients with sHPT has a significant effect in decreasing postparathyroidectomy hospital stay and intravenous calcium.

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