title: Surgical Attitude in Patients with Secondary Hyperparathyroidism Undergoing Dialysis.
abstract: BACKGROUND
  Secondary hyperparathyroidism (SHPT), develops, more or less in all the patients with chronic kidney disease. The pathology is even more severe as it intervenes in a suffering patient in whom the chronic kidney disease frequently associates severe comorbidities. General mortality is higher than in general population. The failure of the medical therapy is an indication for parathyroidectomy.
  
  
  METHODS
  The study analyzed 200 patients with SHPT and chronic kidney disease, admitted in the clinic from October 2011 until January 2015.In this period, 179 (89.5 %) total-parathyroidectomies have been performed a long with 14 (7%) subtotal parathyroidectomies. Also 7 (3.5%) surgical interventions were incomplete.
  
  
  RESULTS
  Overall mortality was 1% (2 patients) and postoperative specific morbidity 3.5% -4 local hemorrhagic complications and 3 cases of dysphonia have been encountered (12% if we include the reinterventions for recurrent hyperparathyroidism - 17 patients).
  
  
  CONCLUSIONS
  Total parathyroidectomy is encumbered by a reduced number of postoperative complications and the risk of recurrent disease in almost nonexistent. The disadvantages of this surgical approach are the tendency of immediate postoperative hypocalcemia and long therm substitution with calcium and vitamine D.
authors.forename: M N
authors.initials: MN
authors.lastname: Bratucu
authors.forename: N D
authors.initials: ND
authors.lastname: Garofil
authors.forename: P A
authors.initials: PA
authors.lastname: Radu
authors.forename: V
authors.initials: V
authors.lastname: Paic
authors.forename: M
authors.initials: M
authors.lastname: Zurzu
authors.forename: V
authors.initials: V
authors.lastname: Goleanu
authors.forename: F
authors.initials: F
authors.lastname: Popa
authors.forename: V
authors.initials: V
authors.lastname: Strambu
authors.forename: D N
authors.initials: DN
authors.lastname: Straja
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood; D016063:Blood Loss, Surgical / Q000517:prevention & control; D055154:Dysphonia / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006962:Hyperparathyroidism, Secondary / Q000209:etiology / Q000401:mortality / Q000601:surgery*; D006996:Hypocalcemia / Q000209:etiology; D008297:Male; D008875:Middle Aged; D010281:Parathyroid Hormone / Q000097:blood; D016105:Parathyroidectomy / Q000009:adverse effects / Q000379:methods; D006435:Renal Dialysis; D051436:Renal Insufficiency, Chronic / Q000628:therapy; D012189:Retrospective Studies; D012307:Risk Factors; D012383:Romania / Q000453:epidemiology; D015996:Survival Rate; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D010281:Parathyroid Hormone