Humanities
Skip to main content Skip to main navigation menu Skip to site footer
  • Register
  • Login
  • Menu
  • Home
  • Current
  • Archives
  • Announcements
  • About
    • About the Journal
    • Submissions
    • Editorial Team
    • Privacy Statement
    • Contact
  • Register
  • Login

Journal of Education, Health and Sport

Laboratory criteria for the persistence of secondary hyperparathyroidism in patients with chronic kidney disease
  • Home
  • /
  • Laboratory criteria for the persistence of secondary hyperparathyroidism in patients with chronic kidney disease
  1. Home /
  2. Archives /
  3. Vol. 10 No. 11 (2020) /
  4. Research Articles

Laboratory criteria for the persistence of secondary hyperparathyroidism in patients with chronic kidney disease

Authors

  • M. Urina Ukrainian Scientific and Practical Center for Endocrine Surgery, Transplantation of Endocrine Organs and Tissues Health Ministry of Ukraine
  • V. Palamarchuk Ukrainian Scientific and Practical Center for Endocrine Surgery, Transplantation of Endocrine Organs and Tissues Health Ministry of Ukraine
  • O. Tovkai Ukrainian Scientific and Practical Center for Endocrine Surgery, Transplantation of Endocrine Organs and Tissues Health Ministry of Ukraine
  • V. Kuts Ukrainian Scientific and Practical Center for Endocrine Surgery, Transplantation of Endocrine Organs and Tissues Health Ministry of Ukraine
  • T. Yuzvenko Ukrainian Scientific and Practical Center for Endocrine Surgery, Transplantation of Endocrine Organs and Tissues Health Ministry of Ukraine

DOI:

https://doi.org/10.12775/JEHS.2020.10.11.007

Keywords

Parathyroid gland, parathyroid hormone, secondary hyperparathyroidism, chronic kidney disease, persistence of secondary hyperparathyroidism.

Abstract

Secondary hyperparathyroidism is a complication of chronic kidney disease in both the non-dialysis and dialysis stages. Even modern advances in drug therapy cannot change the fact that most CKD patients require surgical treatment. The purpose of the treatment of SHPT is to normalize mineral metabolism, prevent bone diseases and prevent extraosseous manifestations. One of the methods of surgical treatment is subtotal parathyroidectomy. Persistence or recurrence of the disease occurs in 5-30% of cases.

Purpose of the study. To determine laboratory criteria for the persistence of SHPT in patients with chronic kidney disease on the second day after parathyroidectomy.

Materials and methods. The study involved 118 patients with end-stage CKD with prolonged renal replacement therapy. All patients had clinical and laboratory signs of secondary hyperparathyroidism. In the period from 2009 to 2019, patients underwent subtotal parathyroidectomy. The patients were divided into two groups. This division was based on the presence of persistence or recurrence of the disease. The main group included 20 patients with laboratory signs of SHPT persistence; the comparison group included 98 patients without signs of disease’s persistence.

Results. Analysis of changes in laboratory parameters in patients with persistence and in patients without signs of disease’s persistence revealed certain differences in their postoperative level. In all 118 cases, there was a significant decrease in PTH in the postoperative period - from 31.5 to 99.6%. Using ROC-analysis, a study was carried out of the possibility of using the degree of PTH reduction as a predictor of the persistent course of SHPT and the optimal cut-off thresholds were established. A decrease in the postoperative level of PTH by 90.9% or more indicates an effective PTE. The maximum value of the test specificity (1.000 (0.968; 1.000)) is achieved when the PTH reduction is 76.0%. At the same time, the maximum value - 1.000 (0.968; 1.000) - reaches the predictive value of a positive test result.

Conclusions. Using the subtotal parathyroidectomy in our study, the persistent of SHPT occurred in 16.9% of cases. A decrease in PTH levels on the second day after surgery less than 76% comparatively to the preoperative level should be considered as a predictor of the development of disease persistence. A reduction in PTH of more than 90.9% may be an indication of sustained remission.

References

Quarles LD, Berkoben M. Management of secondary hyperparathyroidism in dialysis patients. In: UpToDate. Available from: https://www.uptodate.com/contents/management-of-secondary-hyperparathyroidism-in-dialysis-patients (accessed on Mar 5, 2018).

Quarles LD, Berkoben M. Management of secondary hyperparathyroidism in adult nondialysis patients with chronic kidney disease. In: UpToDate. Available from: https://www.uptodate.com/contents/management-of-secondary-hy-yperparathyroidism-in-adult-nondialysis-patients-with-chronic-kidney-disease (accessed on Mar 5, 2018)

Ketteler M, Block GA, Evenepoel P, et al. Executive summary of the 2017 KDIGO Chronic Kidney Disease-Mineral and Bone Disorder (CKD-MBD) Guideline Update: what's changed and why it matters. Kidney Int 2017; 92:26.

Springer International Publishing Switzerland 2017 B.C. Stack, Jr., D.L. Bodenner (eds.), Medical and Surgical Treatment of Parathyroid Diseases. DOI 10.1007/978-3-319-26794-4_1

Sarah Tomasello. Secondary Hyperparathyroidism and Chronic Kidney Disease. Diabetes Spectrum 2008 Jan; 21(1): 19-25. DOI:10.2337/diaspect.21.1.19

Parathyroidectomy in the Management of Secondary Hyperparathyroidism: Clin J Am Soc Nephrol. 2018 Jun 7; 13(6): 952–961. DOI: 10.2215/CJN.10390917.

Mier MV, Rodríguez M. Parathyroidectomy in dialysis patients: Indications, methods, and consequences. Semin Dial. 2019; 32:444–451. DOI:10.1111/sdi.12772

Mira Milas: Parathyroidectomy in end-stage kidney disease. In UpToDate, edited by Carty SE, Chen W, Waltham, MA, UpToDate Inc. Accessed October 25,2017

Monique Nakayama Ohe, Rodrigo Oliveira Santos and co. Intraoperative PTH cut-off definition to predict successful parathyroidectomy in secondary and tertiary hyperparathyroidism. DOI: 10.5935/1808-8694.20130088

Jun Yang Persistent secondary hyperparathyroidism caused by parathyromatosis and supernumerary parathyroid glands in a patient on haemodialysis BMC Nephrology volume 21, Article number: 257 (2020). DOI:10.1186/s12882-020-01917-3

Schneider R, Waldmann J, Ramaswamy A, Fernandez ED, Bartsch DK, Schlosser K. Frequency of ectopic and supernumerary intrathymic parathyroid glands in patients with renal hyperparathyroidism: analysis of 461 patients undergoing initial parathyroidectomy with bilateral cervical thymectomy. World J Surg. 2011;35:1260–5. DOI: 10.1007/s00268-011-1079-6.

Mario Cozzolino and co. Treatment of secondary hyperparathyroidism: the clinical utility of etelcalcetide. Ther Clin Risk Manag. 2017; 13: 679–689. DOI: 10.2147/TCRM.S108490

Gasparri, G., Palestini, N., Freddi, M., Sisto, G., & Camandona, M. (2016). Parathyroid Exploration for Primary Hyperparathyroidism. Primary, Secondary and Tertiary Hyperparathyroidism, 117–132. DOI:10.1007/978-88-470-5758-6_1

Modern Parathyroid Surgery and Intra-Operative Hormone Monitoring; Present Status, Future Concepts DOI: 10.4172/2157-7536.1000190

Monique Nakayama Ohe, Rodrigo Oliveira Santos and co. Intraoperative PTH cutoff definition to predict successful parathyroidectomy in secondary and tertiary hyperparathyroidism. DOI: 10.5935/1808-8694.20130088

Subtotal parathyroidectomy for secondary renal hyperparathyroidism: a 20-year surgical outcome study Langenbecks Arch Surg. 2016; 401(7): 965–974.

DOI:10.1007/s00423-016-1447-7

Melih Kara Evaluation of Intraoperative Parathormone Measurement for Predicting Successful Surgery in Patients Undergoing Subtotal/ Total Parathyroidectomy Due to Secondary Hyperparathyroidism The Laryngoscope 120(8):1538-44, August 2010. DOI: 10.1002/lary.21023

The Value of Intraoperative Parathyroid Hormone Monitoring in Localized Primary Hyperparathyroidism: A Cost Analysis Lilah F. Morris Ann Surg Oncol. 2010 Mar; 17(3): 679–685. DOI:10.1245/s10434-009-0773-1

Shawky et al., J Steroids Horm Sci 2018, 9:1 Modern Parathyroid Surgery and Intra-Operative Hormone Monitoring; Present Status, Future Concepts Journal of Steroids & Hormonal Science DOI: 10.4172/2157-7536.1000190

National Kidney Foundation. K/DOQI clinical practice guidelines for bone metabolism and disease in chronic kidney disease. Am J Kidney Dis 2003;42(4 Suppl 3):S1-201.

Dotzenrath C, Cupisti K, Goretzki E, Mondry A, Vossough A, Grabensee B, et al. Operative treatment of renal autonomous hyperparathyroidism: cause of persistent or recurrent disease in 304 patients. Langenbecks Arch Surg 2003;387:348-54.

DOI: 10.1590/S0102-86502007000200005

Gomes EMS, Nunes RC, Lacativa PGS, Almeida MH, Franco FM, Leal CTS, Patrício Filho PJM, Farias MLF, Gonçalves Ectopic and extranumerary parathyroid glands location in patients with hyperparathyroidism secondary to end stage renal disease. Acta Cir Bras. 2007 Mar-Apr;22(2). DOI:10.1590/S0102-86502007000200005

James W Moor 1, Steven Roberts : Intraoperative parathyroid hormone monitoring to determine long-term success of total parathyroidectomy for secondary hyperparathyroidism. Head Neck 2011 Mar;33(3):293-6. DOI: 10.1002/hed.21441

Monique Nakayama Ohe, Rodrigo Oliveira Santos: Intraoperative PTH cutoff definition to predict successful parathyroidectomy in secondary and tertiary hyperparathyroidism. Braz J Otorhinolaryngol, 2013 Aug; 79(4):494-9. DOI: 10.5935/1808-8694.20130088.

Urina M., Palamarchuk V.: Study of the correlation between the size of the parathyroid adenoma and the level of parathyroid hormone, calcium, phosphorus and vitamin D in the serum of patients with primary hyperparathyroidism. Clinical endocrinology and endocrine surgery, №2(2019). DOI: http://doi.org/10.30978/CEES-2019-2-30

Downloads

  • PDF

Published

2020-11-12

How to Cite

1.
URINA, M., PALAMARCHUK, V., TOVKAI, O., KUTS, V. and YUZVENKO, T. Laboratory criteria for the persistence of secondary hyperparathyroidism in patients with chronic kidney disease. Journal of Education, Health and Sport. Online. 12 November 2020. Vol. 10, no. 11, pp. 69-81. [Accessed 4 July 2025]. DOI 10.12775/JEHS.2020.10.11.007.
  • ISO 690
  • ACM
  • ACS
  • APA
  • ABNT
  • Chicago
  • Harvard
  • IEEE
  • MLA
  • Turabian
  • Vancouver
Download Citation
  • Endnote/Zotero/Mendeley (RIS)
  • BibTeX

Issue

Vol. 10 No. 11 (2020)

Section

Research Articles

License

The periodical offers access to content in the Open Access system under the Creative Commons Attribution-NonCommercial-ShareAlike 4.0

Stats

Number of views and downloads: 511
Number of citations: 0

Search

Search

Browse

  • Browse Author Index
  • Issue archive

User

User

Current Issue

  • Atom logo
  • RSS2 logo
  • RSS1 logo

Information

  • For Readers
  • For Authors
  • For Librarians

Newsletter

Subscribe Unsubscribe

Tags

Search using one of provided tags:

Parathyroid gland, parathyroid hormone, secondary hyperparathyroidism, chronic kidney disease, persistence of secondary hyperparathyroidism.
Up

Akademicka Platforma Czasopism

Najlepsze czasopisma naukowe i akademickie w jednym miejscu

apcz.umk.pl

Partners

  • Akademia Ignatianum w Krakowie
  • Akademickie Towarzystwo Andragogiczne
  • Fundacja Copernicus na rzecz Rozwoju Badań Naukowych
  • Instytut Historii im. Tadeusza Manteuffla Polskiej Akademii Nauk
  • Instytut Kultur Śródziemnomorskich i Orientalnych PAN
  • Instytut Tomistyczny
  • Karmelitański Instytut Duchowości w Krakowie
  • Ministerstwo Kultury i Dziedzictwa Narodowego
  • Państwowa Akademia Nauk Stosowanych w Krośnie
  • Państwowa Akademia Nauk Stosowanych we Włocławku
  • Państwowa Wyższa Szkoła Zawodowa im. Stanisława Pigonia w Krośnie
  • Polska Fundacja Przemysłu Kosmicznego
  • Polskie Towarzystwo Ekonomiczne
  • Polskie Towarzystwo Ludoznawcze
  • Towarzystwo Miłośników Torunia
  • Towarzystwo Naukowe w Toruniu
  • Uniwersytet im. Adama Mickiewicza w Poznaniu
  • Uniwersytet Komisji Edukacji Narodowej w Krakowie
  • Uniwersytet Mikołaja Kopernika
  • Uniwersytet w Białymstoku
  • Uniwersytet Warszawski
  • Wojewódzka Biblioteka Publiczna - Książnica Kopernikańska
  • Wyższe Seminarium Duchowne w Pelplinie / Wydawnictwo Diecezjalne „Bernardinum" w Pelplinie

© 2021- Nicolaus Copernicus University Accessibility statement Shop