The indications and post operative clinical course of subtotal parathyroidectomy for renal osteodystrophy

Abstract

Subtotal parathyroidectomy (PTX) was performed to seven patients with uncontrollable renal osteodytrophy. We decided the indications of PTX as follows,
(1) Severe bone resorption in radiographic findings,
(2) Persistent high A/-P,
(3) High C-PTH level,
(4) Non effectiveness to the treatment of active Vitamine D.
Preoperative clinical symptoms such as bone and joint pain were observed in all the patients, general itching in 4 patients and muscle weakness in 3 patients, but peptic ulcer and psychic disturbance in no patients. These subjective symptoms showed remarkable remission after the surgery.
The rentogenological changes improved in 5 patients and serum Alkaline-phoshatase normalized in 4 patients 8 months after PTX. No patients showed elevation of serum C-PTH even almost one year after operation.