Surgery of Renal Secondary Hyperparathyroidism

次發性副甲狀腺增生之手術

周逢復(Fong-Fu Chou)

《Formosan Journal of Surgery》 42卷4期 (2009/08) Pp. 205-208

https://doi.org/10.29833/FJS.200908.0002

摘要

In most patients on long-term dialysis, an increase in secondary hyperparathyroidism (2(superscript nd) HPT) is noted due to hyper-phosphatemia, a deficit of calcitriol synthesis and hypocalcemia.
Symptoms of bone pain, skin itching, general weakness and insomnia with high IPTH levels (＞ 650 pg/ml), hypercalcemia (＞ 10.1 mg/ml) and hyperphosphatemia (＞ 4.6 mg/dl) are indications for surgery. Total parathyroidectomy or subtotal parathyridectomy is a cost effective procedure to treat symptomatic 2nd HPT. Total parathryoidectomy plus subcutaneous autotransplantation is an easy method to perform and it can avoid long-life hypoparathyroidism, which total parathyroidectomy without autotransplantaion cannot. It is also easy to find and remove the parathyroid tissue if recurrent hyperparathyroidism at the transplantation site is found.

並列摘要

In most patients on long-term dialysis, an increase in secondary hyperparathyroidism (2(superscript nd) HPT) is noted due to hyper-phosphatemia, a deficit of calcitriol synthesis and hypocalcemia.
Symptoms of bone pain, skin itching, general weakness and insomnia with high IPTH levels (＞ 650 pg/ml), hypercalcemia (＞ 10.1 mg/ml) and hyperphosphatemia (＞ 4.6 mg/dl) are indications for surgery. Total parathyroidectomy or subtotal parathyridectomy is a cost effective procedure to treat symptomatic 2nd HPT. Total parathryoidectomy plus subcutaneous autotransplantation is an easy method to perform and it can avoid long-life hypoparathyroidism, which total parathyroidectomy without autotransplantaion cannot. It is also easy to find and remove the parathyroid tissue if recurrent hyperparathyroidism at the transplantation site is found.

並列關鍵字

secondary hyperparathyroidism ； mechanism ； total parathyroidectomy plus subcutaneous autotransplantation