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 ; Rizzoli, René ; Martin, Pierre-Yves ; Robert, John ; Triponez, Frederic
In: World Journal of Surgery, 2008, vol. 32, no. 8, p. 1795-1801
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- Background: Few studies have reported changes of bone mineral density (BMD) after parathyroidectomy in patients with persistent hyperparathyroidism after renal transplantation (3 HPT). Patients and Methods: We retrospectively analyzed 14 patients who underwent successful parathyroidectomy for 3 HPT and who had available BMD data before and after parathyroidectomy. Results: Median follow-up time was 26months (IQR: 16.8-40.2). Serum calcium levels decreased significantly after parathyroidectomy (2.32 ± 0.09 versus 2.66±0.16mmol/l; p<0.01), as did PTH levels (5.1±3.0 versus 27.8±23.7pmol/l; p<0.01). Nine patients (64%) had a steroid-free immunosuppression at follow-up. Mean increase in BMD was 9.5±8.0% for the spine and 9.5±7.9% for the hip (p<0.01 for both sites). Patients with osteoporosis (T-score ≤ 2.5) or osteopenia (T-score ≤ 1) before parathyroidectomy had the biggest increase in BMD (10.7±7.7% in hip BMD and of 12.3±8.1% in spine BMD). Conclusions: Parathyroidectomy is an efficient treatment of osteoporosis and osteopenia in patients with 3 HPT