| Theme |
Kidney transplantation for dialysis room staff -- Recent clinical issues |
| Title |
Management of hyperparathyroidism |
| Author |
Naoto Hamano |
Division of Nephrology, Endocrinology and Metabolism, Tokai University School of Medicine |
| Author |
Masafumi Fukagawa |
Division of Nephrology, Endocrinology and Metabolism, Tokai University School of Medicine |
| [ Summary ] |
Secondary hyperparathyroidism, which persistently increases parathyroid hormone in patients with CKD, is related to bone lesion, mineral metabolic disorder, and vascular calcification not only in the pre-dialysis population but also in kidney transplant recipients. Severe parathyroid cell hyperplasia is unlikely to regress even after kidney transplantation. Secondary hyperparathyroidism, which plays a major role in the pathogenesis of persistent hyperparathyroidism, should be managed before kidney transplantation. Persistent hyperparathyroidism is associated with poor graft survival and increased risk of mortality. Parathyroidectomy or the use of calcimimetics should be considered for reducing PTH levels, controlling mineral and bone disorders, and improving clinical outcomes. |