Increase in bone mineral density after successful parathyroidectomy for tertiary hyperparathyroidism after renal transplantation.
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.
Collaud
Stéphane
S
Department of Thoracic and Endocrine Surgery, University Hospital of Geneva, Rue Micheli-du-Crest 24, 1211 Geneva, Switzerland.
Staub-Zähner
Tania
T
Trombetti
Andrea
A
Clerici
Thomas
T
Marangon
Nicola
N
Binet
Isabelle
I
Myers
Patrick O
PO
Rizzoli
René
R
Martin
Pierre-Yves
PY
Robert
John H
JH
Triponez
Frederic
F
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