만성 콩팥병에 의한 이차성 부갑상선 기능항진증에서 부갑상선 아전절제술의 유용성: 장기 추적 결과

Abstract

Background and Objectives Most secondary hyperparathyroidism is caused by chronic kidney disease. The purpose of this study is to evaluate the effectiveness of subtotal parathyroidectomy in the surgical treatment of renal hyperparathyroidism.Subjects and Method We studied twelve patients with renal hyperparathyroidism who underwent parathyroidectomy from Dec. 2002 to Mar. 2007. We measured the amount of serum, intact parathyroid hormone, calcium, ionized calcium, inorganic phosphorus, and alkaline phosphatase preoperatively and postoperatively.Results Subtotal parathyroidectomy was performed in nine patients, and three enlarged parathyroid glands were removed from three patients. Hyperparathyroidism was observed in four patients (33.3%), normal parathyroid function in six patients (50.0%) and hypoparathyroidism in two patients (16.7%) at 5 years after surgery. All of three patients who had removed three enlarged parathyroid glands showed persistent hyperparathyroidism. Serum ionized calcium was normal in 10 patients and two patients showed hypocalcemia after operation.Conclusion Based on the results of this study, we conclude that subtotal parathyroidectomy may be effective in the surgical treatment of renal hyperparathyroidism. However, further studies are necessary to determine the optimal amount of remnant parathyroid tissue in subtotal parathyroidectomy to maintain normal parathyroid function postoperatively.