title: Hypoparathyroidism associated with severe mineral bone disease postrenal transplantation, treated successfully with recombinant PTH.
abstract: Chronic kidney disease (CKD) is commonly, if not universally, associated with derangements in bone and mineral metabolism, characterized by hyperphosphatemia, low calcitriol levels, and secondary hyperparathyroidism. The spectrum of these disorders is termed renal osteodystrophy or chronic kidney disease-mineral bone disease complex. Aggressive phosphorus control is the cornerstone of management to prevent debilitating complications. Dietary control, phosphate binders, and administration of active vitamin D analogues is the most common initial therapy. Frequently parathyroidectomy is required to reverse or slow the pathological changes when medical management fails. The most common adverse effect of parathyroidectomy is hypocalcemia. We describe a case report of severe hypocalcemia (secondary to surgical hypoparathyroidism) and "hungry bone syndrome," treated successfully with teriparatide (Forteo) in a patient who underwent renal transplantation following subtotal parathyroidectomy.
authors.affiliation: Division of Nephrology and Hypertension, Scott and White Hospital, Temple, Texas 76508, USA.
authors.forename: Ashutosh
authors.initials: A
authors.lastname: Mahajan
authors.forename: Mohanram
authors.initials: M
authors.lastname: Narayanan
authors.forename: Gregory
authors.initials: G
authors.lastname: Jaffers
authors.forename: Luis
authors.initials: L
authors.lastname: Concepcion
mesh_terms: D000368:Aged; D002118:Calcium / Q000097:blood / Q000652:urine; D003404:Creatinine / Q000097:blood; D006801:Humans; D006962:Hyperparathyroidism, Secondary / Q000150:complications* / Q000628:therapy*; D006996:Hypocalcemia / Q000150:complications* / Q000628:therapy*; D016030:Kidney Transplantation; D008274:Magnesium / Q000097:blood / Q000652:urine; D008297:Male; D016105:Parathyroidectomy; D010710:Phosphates / Q000097:blood / Q000652:urine; D011994:Recombinant Proteins / Q000008:administration & dosage / Q000627:therapeutic use; D013577:Syndrome; D019379:Teriparatide / Q000008:administration & dosage / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D010710:Phosphates; D011994:Recombinant Proteins; D019379:Teriparatide; D003404:Creatinine; D008274:Magnesium; D002118:Calcium