Increase in Bone Mineral Density after Successful Parathyroidectomy for Tertiary Hyperparathyroidism after Renal Transplantation

Collaud, Stéphane; Staub-Zähner, Tania; Trombetti, Andrea; Clerici, Thomas; Marangon, Nicola; Binet, Isabelle; Myers, Patrick-Olivier; Rizzoli, René; Martin, Pierre‐Yves; Robert, John; Triponez, Frédéric

doi:10.1007/s00268-008-9495-y

Cited by 26 publications

(10 citation statements)

References 47 publications

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“…Clinical and endocrine status of the patient is indispensable to make the differential diagnosis of the Brown Tumor. Total parathyroidectomy is indicated to treat tertiary HPT, restoring normal serum PTH values, and increasing bone mineral density (12). Patients who underwent partial removal of the glands are more likely to remain in HPT (13).…”

Section: Discussionmentioning

confidence: 99%

Multiple brown tumours of tertiary hyperparathyroidism in a renal transplant recipient: A case report

Magalhães¹,

Osterne²,

Alves³

et al. 2009

Med Oral

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Section: Discussionmentioning

confidence: 99%

Multiple brown tumours of tertiary hyperparathyroidism in a renal transplant recipient: A case report

Magalhães¹,

Osterne²,

Alves³

et al. 2009

Med Oral

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“…Improvement in BMD can be noticed as early as 1 month postoperatively and improved or stabilized over 2-3 years follow-up [64,[114][115][116][117]. However, there is little information on its long-term effect on fracture rates.…”

Section: Other Benefitsmentioning

confidence: 99%

The surgical management of renal hyperparathyroidism

Madorin

Owen

Fraser

et al. 2011

Eur Arch Otorhinolaryngol

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Secondary and tertiary hyperparathyroidism (HPT) develop in patients with renal failure due to a variety of mechanisms including increased phosphorus and fibroblast growth factor 23 (FGF23), and decreased calcium and 1,25-dihydroxy vitamin D levels. Patients present with various bone disorders, cardiovascular disease, and typical laboratory abnormalities. Medical treatment consists of controlling hyperphosphatemia, vitamin D/analog and calcium administration, and calcimimetic agents. Improved medical therapies have led to a decrease in the use of parathyroidectomy (PTX). The surgical indications include parathyroid hormone (PTH) levels >800 pg/ml associated with hypercalcemia and/or hyperphosphatemia despite medical therapy. Other indications include calciphylaxis, fractures, bone pain or pruritis. Transplant recipients often show decreased PTH, calcium and phosphorus levels, but some will have persistent HPT. Evidence suggests that PTX may cause deterioration in renal graft function in the short-term calling into the question the indications for PTX in these patients. Pre-operative imaging is only occasionally helpful except in re-operative PTX. Operative approaches include subtotal PTX, total PTX with or without autotransplantation, and possible thymectomy. Each approach has its proponents, advantages and disadvantages which are discussed. Intraoperative PTH monitoring has a high positive predictive value of cure but a poor negative predictive value and therefore is of limited utility. Hypocalcemia is the most common complication requiring aggressive calcium administration. Benefits of surgery may include improved survival, bone mineral density and alleviation of symptoms.

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“…Vor der Einführung von Cinacalcet gab es zur Behandlung des persistierenden Hyperparathyreoidismus nur die chirurgische Parathyreoidektomie als einzige Therapieoption, wobei in einer kleinen Studie mit 14 Patienten nach Nierentransplantation ein positiver Effekt auf die Knochendichte nachgewiesen wurde (36). Dagegen wurde der Einfluss auf das Frakturrisiko bei Nierentransplantantierten nicht spezifisch untersucht, jedoch konnte für Dialysepatienten eine Reduktion der Frakturhäufigkeit nach Parathyreoidektomie gezeigt werden (37).…”

Section: Parathyreoidektomieunclassified

Knochenstoffwechsel nach Nierentransplantation

Fiedler¹

2017

Osteologie

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ZusammenfassungVeränderungen im Knochenstoffwechsel nach soliden Organtransplantationen, insbesondere nach Nierentransplantation, der mit über 2000 Transplantationen pro Jahr häufigsten Form, stellen immer wieder eine Herausforderung für den klinisch tätigen Osteologen dar. Die Besonderheiten der Transplantationsosteopathie (TO) liegen zum einem in der multifaktoriellen Pathogenese (u. a. Medikamente, vor Transplantation bestehende Knochenstörungen, hormonelle und weitere Faktoren) und zum anderen in den eingeschränkten Leitlinien, da nur eine geringe Zahl an evidenzbasierten Studien berücksichtigt werden können. In diesem Übersichts-artikel wird auf die aktuellen Aspekte bezüglich der Ursachen, Leitlinien, Diagnostik und der Therapiemöglichkeiten eingegangen. Im Speziellen soll dabei die Bedeutung der Knochenbiopsie und der Osteodensitometrie als diagnostische Tools und die Behandlung der frakturgefährdeten Patienten im ersten Jahr nach der Transplantation hervorgehoben werden.

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Increase in Bone Mineral Density after Successful Parathyroidectomy for Tertiary Hyperparathyroidism after Renal Transplantation

Cited by 26 publications

References 47 publications

Multiple brown tumours of tertiary hyperparathyroidism in a renal transplant recipient: A case report

Multiple brown tumours of tertiary hyperparathyroidism in a renal transplant recipient: A case report

The surgical management of renal hyperparathyroidism

Knochenstoffwechsel nach Nierentransplantation

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