BACKGROUND Tertiary hyperparathyroidism continues to cause significant morbidity in patients with chronic renal failure. This is frequently resistant to medical management and may ultimately require a surgical parathyroidectomy. Recent studies have reported upon the technique of percutaneous ethanol ablation for both primary and tertiary hyperparathyroidism. In this study we report on a 5 year ...

HYPOTHESIS A clearly localizing sestamibi scan predicts a successful minimally invasive radioguided parathyroidectomy that can be performed with a shorter operative time, low morbidity, and decreased duration of hospital stay. DESIGN Review of prospectively gathered data and patient medical records. SETTING Hospitalized care. PATIENTS AND METHODS Parathyroidectomy was performed on 55 pati...

BACKGROUND Controversy exists concerning the best treatment for asymptomatic primary hyperparathyroidism (PHPT) when the National Institutes of Health consensus conference criteria for parathyroidectomy are not met. We hypothesized that parathyroidectomy would be more cost-effective than observation or pharmacologic therapy for these patients. METHODS Cost-effectiveness analysis was performed...

Background: In hemodialysis patients, parathyroid hormone is considered a risk factor of cardiovascular disease. Moreover, cardiovascular disease is the leading cause of mortality in hemodialysis patients. The aim of this study was to assess the effect of parathyroidectomy on cardiac performance in hemodialysis patients. Methods: This is a single hospital retrospective analysis on fifteen hemod...

OBJECTIVE To examine changes in presentation of primary hyperparathyroidism and rates of parathyroidectomy in Northern Sydney (the Northern Sydney Area Heath Service) and New South Wales (NSW). DESIGN Retrospective case series January 1962 - December 2001 and audit of the NSW Department of Health inpatient database (1993-1999). SETTING University of Sydney Endocrine Surgical Unit, Royal Nor...

BACKGROUND Management of post-parathyroidectomy hypocalcemia in dialysis patients is not well defined. We reviewed published approaches to treatment in an effort to define a clinical algorithm for controlling serum calcium levels post-operatively. METHODS We conducted a PubMed search for the years 1980-2003 with the keywords "hypocalcemia" and "parathyroidectomy". Only English language and hu...

Secondary hyperparathyroidism increases morbidity and mortality in hemodialysis patients. The Kidney Disease Outcomes Quality Initiative Guidelines recommend parathyroidectomy for patients with chronic kidney disease and parathyroid hormone concentrations exceeding 800 pg/mL; however, this concentration represents an arbitrary cut-off value. The present study was conducted to identify factors i...

BACKGROUND Secondary hyperparathyroidism (SHPT) is associated with adverse outcomes in patients receiving maintenance dialysis. Parathyroidectomy is a treatment for SHPT; whether parathyroidectomy utilization varies geographically in the US is unknown. METHODS A retrospective cohort analysis was undertaken to identify all patients aged 18 years or older who were receiving in-center hemodialys...

OBJECTIVE To assess the incidence and clinical relevance of inadvertent parathyroidectomy during thyroidectomy, and the possibility of reducing its occurrence. DESIGN Retrospective study. SETTING University hospital. PATIENTS Consecutive patients who underwent thyroidectomy from 1999 to 2005, divided into 2 groups (group 1, those with inadvertent parathyroidectomy; and group 2, those with...

Although the therapeutic approach to managing hyperparathyroidism has changed dramatically, it is unknown whether parathyroidectomy rates continue to decline in the United States. Parathyroidectomy rates were studied in successive annual national cohorts, prevalent on hemodialysis on January 1 of 1992 to 2002, with Medicare as primary payer. Parathyroidectomy was defined as International Classi...