| Theme | Testify the concepts of renal osteodystrophy and chronic kidney disease-bone and mineral disorder (CKD-MBD) | |
|---|---|---|
| Title | Surgical indications for advanced secondary hyperparathyroidism refractory to medical treatment | |
| Publish Date | 2015/06 | |
| Author | Yoshihiro Tominaga | Department of Endocrine Surgery, Nagoya Daini Red Cross Hospital |
| [ Summary ] | In Japan the number of parathyroidectomies for secondary hyperparathyroidism (SHPT) has been dramatically decreased after the introduction of cinacalcet in 2008. However, when SHPT is resistant to cinacalcet, PTx is required. The level of PTH > 500 pg/mL or PTH > 300 pg/mL with hyperphosphatemia and/or hypercalcemia are indicators used to decide on indication for PTx. The detection of an enlarged parathyroid gland with ultrasonography is a supportive factor for required PTx. Mortality, QOL, risk of bone fractures and cost effectiveness can all be improved with PTx. PTx should be always kept in our mind for treatment of SHPT. | |