Abstract
We performed total parathyroidectomy for the 2 cases of renal secondary hyperpar-thyroidism and a part of the parathyroid gland was transplanted in the right arm intra-muscularly.
The two cases had the same interval between the start of hemodialysis and the appea-rance of the symptoms and their resected parathyroids weighed almost equally.
But the serum calcium levels immediately after the operation was remarkably different, i. e., in the first case we had to use intravenous Calcicol (Ca. gluconate) in an undiluted solution continuously for over 14 days after the operation (maximally 40 ampules per day);while in the second case it was necessary to use Calcicol only for 4 days after the operation (maximally 25 ampules per day) to avoid tetany.
Among the preoperative data, only alkali-phosphatase level was very different between two cases;i. e., 121.8 K. A. U. in the first case, 23.2 K. A. U. in the second case.
We did not find significant differences in the levels of serum PTH, Ca, and P, between two cases.
Thus, we concluded that the serum alkali-phosphatase level implies most precisely se-verity of the “hungry bone”in the secondary hyperparathyroidism.
