Results of parathyroidectomy for autonomous hyperparathyroidism

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Abstract
Autonomous hyperparathyroidism occurred in 15% of 152 patients maintained by long-term home dialysis during the past 9 yr. Twenty-two patients with elevated serum parathormone levels and progressive bone disease in the presence of normal serum phosphate and Ca levels were treated by subtotal parathyroidectomy. All had parathyroid hyperplasia. Eighteen of the 22 patients are presently alive and undergo dialysis. Symptoms of bone pain, pruritus and muscle cramps had improved in 3/4 of the patients. The serum parathormone level decreased from a preoperative average of 576 .mu.lEq/ml to an average of 188 .mu.lEq/ml postoperatively. All 18 patients, observed for 6-77 mo., showed improvement in X-ray films of their bone disease. The autonomous hyperparathyroidism of end-stage renal disease is corrected by subtotal parathyroidectomy and the effect is sustained.

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