2019, Number 6
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Rev Med Inst Mex Seguro Soc 2019; 57 (6)
Long-term efficacy of parathyroidectomy in secondary and tertiary hyperparathyroidism
González-Cantú A, Romero-Ibarguengoitia ME, Quintanilla-Flores DL, Reza-Albarrán A, Herrera-Hernández M, Pantoja-Millán JP, Sierra-Salazar M, Velázquez-Fernández D, Gómez-Pérez FJ
Language: Spanish
References: 23
Page: 371-378
PDF size: 190.40 Kb.
ABSTRACT
Background: Secondary and tertiary hyperparathyroidism
(SHPT and THPT), are complications of chronic kidney
disease (CKD), characterized by high levels of serum
parathormone, hyperphosphatemia or hypercalcemia,
respectively. If diet and pharmacological therapies fail,
clinical practice guidelines suggest parathyroidectomy
(PTX). Some studies have described its effectiveness and
safety, but these have not included Mexican population.
Objective: To describe long-term effectiveness of PTX in
Mexican patients with SHPT or THPT.
Material and methods: Observational and retrospective
study of patients treated with PTX between 1995 and
2014 in a third level hospital in Mexico City. The
analyses included the follow-up of medical treatment and
biochemical assessment every three months during the
first year, and the last evaluation. Permutation and chi
square tests were used.
Results: The study included 27 patients (14 women). The
follow-up mean was 39 months; 61.5% had SHPT. All
biochemical parameters, except magnesium, were reduced
in the first year of follow-up. In the long term, SHPT was
controlled in 80% using PTH under a 300 pg/mL criterion,
and 90% in patients with THPT using calcium criterion.
Persistent hypocalcemia was present in 11.5% of cases.
Conclusions: Mexican patients with SHPT and THPT
could be successfully treated with surgery with low risk of
hypocalcemia.
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