Pathophysiology and Treatment of Secondary and Tertiary Hyperparathyroidism

  • Ulrich Güller
  • Michael Mayr

25.7 Summary

The surgical indications for patients with secondary or tertiary HPTH are not clearly defined. In general patients who develop PTH autonomy and do not respond to medical management will require PTX. It is also critical to screen all patients who are potential renal transplant recipients for secondary HPTH and to treat severe HPTH prior to transplantation. Both subtotal PTX and total cervical PTX with immediate heterotopic parathyroid transplantation are accepted surgical techniques. Cryopreservation is extremely useful and should always be employed during surgery. The intraoperative PTH assay appears to be a useful adjunct in early studies.


Parathyroid Gland Secondary Hyperparathyroidism Phosphate Binder Parathyroid Tissue Nephrol Dial Transplant 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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Copyright information

© Springer-Verlag Berlin Heidelberg 2007

Authors and Affiliations

  • Ulrich Güller
    • 1
  • Michael Mayr
    • 2
  1. 1.Department of Surgery, Divisions of General Surgery and Surgical ResearchUniversity of BaselBaselSwitzerland
  2. 2.Division of Transplantation Immunology and Nephrology, Department of Internal MedicineUniversity of BaselBaselSwitzerland

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