Parathyroidectomy after kidney transplantation: short-and long-term impact on renal function

• Main Authors: Gustavo Fernandes Ferreira, Fabio Luiz de Menezes Montenegro, David Jose Machado, Luiz Estevam Ianhez, William Carlos Nahas, Elias David-Neto
• Format: Article
• Language: English
• Published: Faculdade de Medicina / USP 2011-01-01
• Series: Clinics
• Subjects: Kidney Transplant; Parathyroid Hormone; Parathyroidectomy; Renal Function; Surgery
• Online Access: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1807-59322011000300012
• ISSN: 1807-5932; 1980-5322

INTRODUCTION: Kidney transplantation corrects endocrine imbalances. Nevertheless, these early favorable events are not always followed by rapid normalization of parathyroid hormone secretion. A possible deleterious effect of parathyroidectomy on kidney transplant function has been reported. This study aimed to compare acute and longterm renal changes after total parathyroidectomy with those occurring after general surgery. MATERIALS AND METHODS: This was a retrospective case-controlled study. Nineteen patients with persistent hyperparathyroidism underwent parathyroidectomy due to hypercalcemia. The control group included 19 patients undergoing various general and urological operations. RESULTS: In the parathyroidectomy group, a significant increase in serum creatinine from 1.58 to 2.29 mg/dl (P < 0.05) was noted within the first 5 days after parathyroidectomy. In the control group, a statistically insignificant increase in serum creatinine from 1.49 to 1.65 mg/dl occurred over the same time period. The long-term mean serum creatinine level was not statistically different from baseline either in the parathyroidectomy group (final follow-up creatinine = 1.91 mg/dL) or in the non-parathyroidectomy group (final follow-up creatinine = 1.72 mg/dL). CONCLUSION: Although renal function deteriorates in the acute period following parathyroidectomy, long-term stabilization occurs, with renal function similar to both preoperative function and to a control group of kidney-transplanted patients who underwent other general surgical operations by the final follow up.