title: Increase in bone mineral density after successful parathyroidectomy for tertiary hyperparathyroidism after renal transplantation.
abstract: BACKGROUND
  Few studies have reported changes of bone mineral density (BMD) after parathyroidectomy in patients with persistent hyperparathyroidism after renal transplantation (3 HPT).
  
  
  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 26 months (IQR: 16.8-40.2). Serum calcium levels decreased significantly after parathyroidectomy (2.32 +/- 0.09 versus 2.66 +/- 0.16 mmol/l; p < 0.01), as did PTH levels (5.1 +/- 3.0 versus 27.8 +/- 23.7 pmol/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 <or= 2.5) or osteopenia (T-score <or= 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.
authors.affiliation: Department of Thoracic and Endocrine Surgery, University Hospital of Geneva, Rue Micheli-du-Crest 24, 1211 Geneva, Switzerland.
authors.forename: Stéphane
authors.initials: S
authors.lastname: Collaud
authors.forename: Tania
authors.initials: T
authors.lastname: Staub-Zähner
authors.forename: Andrea
authors.initials: A
authors.lastname: Trombetti
authors.forename: Thomas
authors.initials: T
authors.lastname: Clerici
authors.forename: Nicola
authors.initials: N
authors.lastname: Marangon
authors.forename: Isabelle
authors.initials: I
authors.lastname: Binet
authors.forename: Patrick O
authors.initials: PO
authors.lastname: Myers
authors.forename: René
authors.initials: R
authors.lastname: Rizzoli
authors.forename: Pierre-Yves
authors.initials: PY
authors.lastname: Martin
authors.forename: John H
authors.initials: JH
authors.lastname: Robert
authors.forename: Frederic
authors.initials: F
authors.lastname: Triponez
mesh_terms: D015519:Bone Density / Q000502:physiology*; D005260:Female; D006801:Humans; D006961:Hyperparathyroidism / Q000209:etiology* / Q000503:physiopathology / Q000601:surgery*; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D016105:Parathyroidectomy; D012189:Retrospective Studies; D016896:Treatment Outcome