Parathyroïdectomie pour hyperparathyroïdie secondaire dans l'insuffisance rénale

Out of a total of 304 patients submitted to treatment by haemodialysis for chronic renal insufficiency, 12 presented signs of secondary hyperparathyroidism ( 11 while under haemodialysis, 1 before the haemodialysis). The operative indications were clinical signs (nausea and vomiting, pruritus, osteo-articular pain and articular fluxion), and radiological signs (osteolysis and metastic calcifications), the biological data (calcaemia, phosphoraemia, alkaline phosphatase, parathormone levels) being valueless from this point of view. Eleven patients were parathyroidectomised. Nine were followed up over a sufficiently remote period of one year at least. In 5 cases a subtotal parathyroidectomy was done, leaving in place a stump of parathyroid tissue with the volume of a normal parathyroid: these 5 patients were cured. In the 4 other cases, the resection was less extensive (1 1/2 -3 1/2 parathyroids removed): 1 patient was cured: 1 was improved: in the latter 2 who had not been improved by the parathyroidectomy, the symptoms disappeared after renal transplantation.SCOPUS: NotDefined.j