Renal Failure after Surgery for Primary Hyperparathyroidism: Is Acute Reduction of Parathyroid Function a Risk Factor?

Pulse wave velocity in primary hyperparathyroidism and effect of surgical therapy

“…Different effects of PTH on the vasculature, including vasodilatation or vasoconstriction, have been observed. 20 In a recent study, a positive correlation of PTH with elevated levels of aldosterone has been reported 21 and thus differences in plasma aldosterone levels may also play a role. However, in previous studies, no similar correlation of PTH with aldosterone was observed and, furthermore, there were no differences in aldosterone levels before and after surgery in patients with PH.…”

“…PTH might affect the renal microcirculation through the influence of renal blood flow, glomerular filtration rate and excretory functions. 20,24 The exact mechanism of the PTH-mediated effect on renal blood flow is not clear, as both vasodilatory and vasoconstrictive effects of PTH on glomerular vessels have been described. 20 PTX is usually associated with renal function improvement, 1 but renal functional impairment after PTX is rarely described in the literature.…”

“…20,24 The exact mechanism of the PTH-mediated effect on renal blood flow is not clear, as both vasodilatory and vasoconstrictive effects of PTH on glomerular vessels have been described. 20 PTX is usually associated with renal function improvement, 1 but renal functional impairment after PTX is rarely described in the literature. 20 Although we observed mild increases in serum creatinine and decreases in estimated glomerular filtration rate after surgery (with borderline statistical significance), our population lacked patients with the manifestation of renal failure.…”

“…20 PTX is usually associated with renal function improvement, 1 but renal functional impairment after PTX is rarely described in the literature. 20 Although we observed mild increases in serum creatinine and decreases in estimated glomerular filtration rate after surgery (with borderline statistical significance), our population lacked patients with the manifestation of renal failure. We believe that these insignificant results could be influenced either by a relatively small number of post-PTX subjects or other contributory cofactors.…”

“…The decrease in PTH after PTX with changes in renal blood flow might be responsible for the acute alteration of renal function. 20 In the long term, however, these hemodynamic changes may contribute to attenuation of the progression of renal failure. As our patients were followed up for only 6 months after surgery, we were not able to assess long-term effects of PTX among our subject population.…”