Transitory increase in creatinine levels after parathyroidectomy: evidence of another action of the parathyroid glands?

Abstract

Objective: Little information is available on glomerular function changes after surgical treatment of primary hyperparathyroidism. The acute effects of some head and neck operations on renal function were studied. Materials and methods: Retrospective analysis of changes in creatinine levels and estimated glomerular filtration rate (eGFR) after surgery. Preoperative values were compared with values available until 72 hours after the operation. Results: In tertiary hyperparathyroidism, mean preoperative and postoperative eGFR values were 57.7 mL/min and 40.8 mL/min (p < 0.0001), respectively. A similar decrease was observed after parathyroidectomy for primary hyperparathyroidism, from 85.4 mL/min to 64.3 mL/min (p < 0.0001). After major head and neck procedures, there was a slight increase in eGFR (from 94.3 mL/min to 105.4 mL/min, p = 0.002). Conclusions: Parathyroidectomy may be followed by a transient decrease in eGFR that is not often observed in other head and neck operations. Arq Bras Endocrinol Metab. 2011;55(4):249-55 Keywords Creatinine; hyperparathyroidism; acute kidney failure; parathyroid hormone; parathyroidectomy RESUMO Objetivo: Há pouca informação sobre alterações da função glomerular após o tratamento cirúrgico do hiperparatireoidismo primário. O efeito agudo sobre a função renal foi estudado após algumas operações em cirurgia de cabeça e pescoço. Materiais e métodos: Análise retrospectiva dos níveis de creatinina e da taxa de filtração glomerular estimada (eGFR). Os valores pré-operatórios foram comparados aos valores disponíveis até 72 horas após a operação. Resultados: No hiperparatireoidismo terciário, os valores médios pré e pós-operatórios da eGFR foram 57,7 mL/min e 40,8 mL/min (p < 0,0001), respectivamente. O decréscimo após paratireoidectomia por hiperparatireoidismo primário foi de 85,4 mL/min para 64,3 mL/min (p < 0,0001). Após operações maiores de cabeça e pescoço, houve leve elevação da eGFR (de 94,3 mL/min para 105,4 mL/min, p = 0,002). Conclusões: A paratireoidectomia pode ser seguida de uma redução transitória na eGFR que não é frequentemente observada após outras operações em cabeça e pescoço. Arq Bras Endocrinol Metab. 2011;55(4):249-55 Descritores Creatinina; hiperparatireoidismo; falência renal aguda; hormônio paratireoideo; paratireoidectomia

Total parathyroidectomy in a large cohort of cases with hyperparathyroidism associated with multiple endocrine neoplasia type 1: experience from a single academic center

“…The prevalence of parathyroid carcinomas in MEN1 tends to be much lower than in sporadic cases of HPT (33). Accordingly, we have seen no cases of parathyroid carcinoma in our HPT/MEN1 series, compared with higher frequencies observed in our sporadic HPT cases, in which we observed a 1.8–6.1% frequency of parathyroid carcinoma (34),(35). …”

Parathyroid surgery during the COVID-19 pandemic: Time to think about the “New Normal”

“…Even calcium levels below 14 mg/dL may jeopardize the kidney graft in this population. Although a transient rise in creatinine is observed after parathyroidectomy in kidney transplant patients, no significant changes persist in the long term ( 32 , 33 ).…”

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“…We showed that patients treated for adenomas, typically with a short localized surgery, presented with the same pattern of kidney dysfunction as those with more extensive procedures, such as total parathyroidectomy with auto transplantation performed in MEN 1-related PHPT. We previously observed that renal dysfunction was not observed in patients undergoing other head and neck procedures [43].…”