title: Parathyroidectomy after kidney transplantation: short-and long-term impact on renal function.
abstract: BACKGROUND
  Kidney transplantation corrects endocrine imbalances. Nevertheless, these early favorable events are not always followed by rapid normalization of parathyroid hormone secretion. A possible deleterious effect of parathyroidectomy on kidney transplant function has been reported. This study aimed to compare acute and longterm renal changes after total parathyroidectomy with those occurring after general surgery.
  
  
  METHODS
  This was a retrospective case-controlled study. Nineteen patients with persistent hyperparathyroidism underwent parathyroidectomy due to hypercalcemia. The control group included 19 patients undergoing various general and urological operations.
  
  
  RESULTS
  In the parathyroidectomy group, a significant increase in serum creatinine from 1.58 to 2.29 mg/dl (P < 0.05) was noted within the first 5 days after parathyroidectomy. In the control group, a statistically insignificant increase in serum creatinine from 1.49 to 1.65 mg/dl occurred over the same time period. The long-term mean serum creatinine level was not statistically different from baseline either in the parathyroidectomy group (final follow-up creatinine = 1.91 mg/dL) or in the non-parathyroidectomy group (final follow-up creatinine = 1.72 mg/dL).
  
  
  CONCLUSIONS
  Although renal function deteriorates in the acute period following parathyroidectomy, long-term stabilization occurs, with renal function similar to both preoperative function and to a control group of kidney-transplanted patients who underwent other general surgical operations by the final follow up.
authors.affiliation: Renal Transplant Unit, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil. gustavofferreira@gmail.com
authors.forename: Gustavo Fernandes
authors.initials: GF
authors.lastname: Ferreira
authors.forename: Fabio Luiz de Menezes
authors.initials: FL
authors.lastname: Montenegro
authors.forename: David Jose
authors.initials: DJ
authors.lastname: Machado
authors.forename: Luiz Estevam
authors.initials: LE
authors.lastname: Ianhez
authors.forename: William Carlos
authors.initials: WC
authors.lastname: Nahas
authors.forename: Elias
authors.initials: E
authors.lastname: David-Neto
mesh_terms: D000328:Adult; D000367:Age Factors; D016022:Case-Control Studies; D003404:Creatinine / Q000032:analysis; D005260:Female; D006801:Humans; D006962:Hyperparathyroidism, Secondary / Q000601:surgery; D007668:Kidney / Q000503:physiopathology*; D016030:Kidney Transplantation / Q000009:adverse effects / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D010280:Parathyroid Glands / Q000601:surgery; D010281:Parathyroid Hormone / Q000378:metabolism; D016105:Parathyroidectomy / Q000009:adverse effects; D011184:Postoperative Period; D012189:Retrospective Studies; D012737:Sex Factors; D013997:Time Factors
chemical_list: D010281:Parathyroid Hormone; D003404:Creatinine