title: Current indications to parathyroidectomy in CKD patients before and after renal transplantation.
abstract: Secondary hyperparathyroidism (SHP) is one of the most challenging complications in the most advanced stages of end-stage renal disease. In the last decade, newly available medical tools have greatly increased the possibilities for controlling SHP. However, one of these tools, cinacalcet, has not yet been approved  for its use in transplanted patients and the evidence for its safety in this clinical setting is still incomplete. For these reasons, many questions still remain open for the clinical nephrologist: when to consider a parathyroidectomy (PTX)  in a patient on a waiting list for kidney transplant  (KTx); when to recommend PTX after KTx; when could a regression of parathyroid hyperplasia  be expected at any time after KTx. In the present paper, we will briefly deal with these questions in the light of an unusual clinical case.
authors.affiliation: Department of Medicine and Medical Specialties, Unit of Nephrology, Dialysis and Renal Transplant, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan - Italy.
authors.forename: Piergiorgio
authors.initials: P
authors.lastname: Messa
authors.forename: Anna
authors.initials: A
authors.lastname: Regalia
authors.forename: Carlo Maria
authors.initials: CM
authors.lastname: Alfieri
authors.forename: Donata
authors.initials: D
authors.lastname: Cresseri
authors.forename: Laura
authors.initials: L
authors.lastname: Forzenigo
authors.forename: Maria Teresa
authors.initials: MT
authors.lastname: Gandolfo
authors.forename: Maria Pia
authors.initials: MP
authors.lastname: Rastaldi
mesh_terms: D002614:Chelating Agents / Q000627:therapeutic use; D000069449:Cinacalcet; D006801:Humans; D006934:Hypercalcemia / Q000209:etiology / Q000628:therapy*; D006961:Hyperparathyroidism / Q000209:etiology / Q000601:surgery; D006962:Hyperparathyroidism, Secondary / Q000209:etiology* / Q000628:therapy*; D006965:Hyperplasia / Q000628:therapy; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000601:surgery; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D009281:Naphthalenes / Q000627:therapeutic use; D056687:Off-Label Use; D010280:Parathyroid Glands / Q000473:pathology; D016105:Parathyroidectomy; D014850:Waiting Lists
chemical_list: D002614:Chelating Agents; D007166:Immunosuppressive Agents; D009281:Naphthalenes; D000069449:Cinacalcet