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Parathyroidectomy in Chronic Kidney Disease

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Parathyroid Glands in Chronic Kidney Disease

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Abstract

Chronic Kidney Disease (CKD) associates with disturbed modulation of hormones involved in calcium and phosphate homeostasis, with development of secondary hyperparathyroidism (SHPT). SHPT includes not only divalent ions derangements, but also renal bone disease (high turnover, low turnover and/or osteomalacia) and accelerated vascular and ectopic calcifications. In this way, SHPT resembles a true clinical syndrome named CKD-MBD, which is a recognized risk factor of all-cause and cardiovascular death. Long lasting stimulation of parathyroid hormone synthesis and secretion, as observed in CKD, causes specific and progressive histological changes responsible for the development of nodular hyperplastic glands unresponsive to physiologic inhibitors and thus characterized by hypercalcemia, elevated PTH levels and resistance to the available medical therapies. In these cases, surgical parathyroidectomy (PTX) becomes the only therapeutic option. In this chapter we review current evidence on indications, types and clinical outcomes of PTX from a practical and clinical point of view.

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Authors and Affiliations

  1. Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy

    Sandro Mazzaferro, Silverio Rotondi, Martia Pasquali, Angelo Mazzarella & Lida Tartaglione

  2. Policlinico Umberto I Hospital, Nephrology Unit, Rome, Italy

    Sandro Mazzaferro, Silverio Rotondi, Martia Pasquali, Angelo Mazzarella & Lida Tartaglione

Authors
  1. Sandro Mazzaferro
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  2. Silverio Rotondi
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  3. Martia Pasquali
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  4. Angelo Mazzarella
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  5. Lida Tartaglione
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Corresponding author

Correspondence to Sandro Mazzaferro .

Editor information

Editors and Affiliations

  1. Internal Medicine - Nephrology, Grigore T. Popa University of Medicine and Pharmacy, Iași, Romania

    Adrian Covic

  2. Renal Unit, Guy's and St Thomas' NHS Foundation Hospital, London, UK

    David Goldsmith

  3. Nephrology-Dialysis Service, AURA Nord Saint Ouen, Saint Ouen, France

    Pablo A. Ureña Torres

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Mazzaferro, S., Rotondi, S., Pasquali, M., Mazzarella, A., Tartaglione, L. (2020). Parathyroidectomy in Chronic Kidney Disease. In: Covic, A., Goldsmith, D., Ureña Torres, P. (eds) Parathyroid Glands in Chronic Kidney Disease. Springer, Cham. https://doi.org/10.1007/978-3-030-43769-5_12

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  • DOI: https://doi.org/10.1007/978-3-030-43769-5_12

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-43768-8

  • Online ISBN: 978-3-030-43769-5

  • eBook Packages: MedicineMedicine (R0)

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