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Surgery for Renal Hyperparathyroidism in the Era of Cinacalcet: A Single-Center Experience

BACKGROUND AND AIMS: There are only few data on the influence of cinacalcet on the outcome of parathyroidectomy in patients with renal hyperparathyroidism. Indication and timing of surgery have changed since its introduction, especially with regard to kidney transplantation. Therefore, we retrospect...

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Autores principales: Mogl, M. T., Skachko, T., Dobrindt, E. M., Reinke, P., Bures, C., Pratschke, J., Rayes, N.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7961642/
https://www.ncbi.nlm.nih.gov/pubmed/31906794
http://dx.doi.org/10.1177/1457496919897004
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author Mogl, M. T.
Skachko, T.
Dobrindt, E. M.
Reinke, P.
Bures, C.
Pratschke, J.
Rayes, N.
author_facet Mogl, M. T.
Skachko, T.
Dobrindt, E. M.
Reinke, P.
Bures, C.
Pratschke, J.
Rayes, N.
author_sort Mogl, M. T.
collection PubMed
description BACKGROUND AND AIMS: There are only few data on the influence of cinacalcet on the outcome of parathyroidectomy in patients with renal hyperparathyroidism. Indication and timing of surgery have changed since its introduction, especially with regard to kidney transplantation. Therefore, we retrospectively analyzed patients undergoing parathyroidectomy for renal hyperparathyroidism in our institution. MATERIAL AND METHODS: Between 2008 and 2015, 196 consecutive operations in 191 patients were analyzed. About 80 operations (41%) were performed in patients receiving cinacalcet compared with 116 operations (59%) in patients without cinacalcet. Clinical data, preoperative medication, pre- and postoperative laboratory values, type and details of surgery including complications, as well as cardiovascular complications and kidney transplantation with graft function were recorded. RESULTS: Demographical data were similar in patients with or without cinacalcet treatment. A total of 54% of patients received a kidney graft before or after parathyroidectomy. Pre- and postoperative parathormone levels were similar in both groups (preoperatively 755 vs 742 ng/L, postoperatively 50 vs 46 ng/L, p > 0.10), whereas patients with cinacalcet showed significantly lower calcium levels preoperatively (2.28 vs 2.41 mmol/L, p = 0.0002). There was no difference in recurrence or persistence of hyperparathyroidism, duration of surgery, hospital stay, or complication rate. Creatinine levels in patients with tertiary hyperparathyroidism were similar after 1-year follow-up. CONCLUSION: Cinacalcet did not influence outcome of patients with parathyroidectomy for renal hyperparathyroidism and can be safely offered to patients not responding to medical treatment.
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spelling pubmed-79616422021-03-30 Surgery for Renal Hyperparathyroidism in the Era of Cinacalcet: A Single-Center Experience Mogl, M. T. Skachko, T. Dobrindt, E. M. Reinke, P. Bures, C. Pratschke, J. Rayes, N. Scand J Surg Original Research Articles BACKGROUND AND AIMS: There are only few data on the influence of cinacalcet on the outcome of parathyroidectomy in patients with renal hyperparathyroidism. Indication and timing of surgery have changed since its introduction, especially with regard to kidney transplantation. Therefore, we retrospectively analyzed patients undergoing parathyroidectomy for renal hyperparathyroidism in our institution. MATERIAL AND METHODS: Between 2008 and 2015, 196 consecutive operations in 191 patients were analyzed. About 80 operations (41%) were performed in patients receiving cinacalcet compared with 116 operations (59%) in patients without cinacalcet. Clinical data, preoperative medication, pre- and postoperative laboratory values, type and details of surgery including complications, as well as cardiovascular complications and kidney transplantation with graft function were recorded. RESULTS: Demographical data were similar in patients with or without cinacalcet treatment. A total of 54% of patients received a kidney graft before or after parathyroidectomy. Pre- and postoperative parathormone levels were similar in both groups (preoperatively 755 vs 742 ng/L, postoperatively 50 vs 46 ng/L, p > 0.10), whereas patients with cinacalcet showed significantly lower calcium levels preoperatively (2.28 vs 2.41 mmol/L, p = 0.0002). There was no difference in recurrence or persistence of hyperparathyroidism, duration of surgery, hospital stay, or complication rate. Creatinine levels in patients with tertiary hyperparathyroidism were similar after 1-year follow-up. CONCLUSION: Cinacalcet did not influence outcome of patients with parathyroidectomy for renal hyperparathyroidism and can be safely offered to patients not responding to medical treatment. SAGE Publications 2020-01-06 2021-03 /pmc/articles/PMC7961642/ /pubmed/31906794 http://dx.doi.org/10.1177/1457496919897004 Text en © The Finnish Surgical Society 2020 https://creativecommons.org/licenses/by-nc/4.0/ This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Original Research Articles
Mogl, M. T.
Skachko, T.
Dobrindt, E. M.
Reinke, P.
Bures, C.
Pratschke, J.
Rayes, N.
Surgery for Renal Hyperparathyroidism in the Era of Cinacalcet: A Single-Center Experience
title Surgery for Renal Hyperparathyroidism in the Era of Cinacalcet: A Single-Center Experience
title_full Surgery for Renal Hyperparathyroidism in the Era of Cinacalcet: A Single-Center Experience
title_fullStr Surgery for Renal Hyperparathyroidism in the Era of Cinacalcet: A Single-Center Experience
title_full_unstemmed Surgery for Renal Hyperparathyroidism in the Era of Cinacalcet: A Single-Center Experience
title_short Surgery for Renal Hyperparathyroidism in the Era of Cinacalcet: A Single-Center Experience
title_sort surgery for renal hyperparathyroidism in the era of cinacalcet: a single-center experience
topic Original Research Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7961642/
https://www.ncbi.nlm.nih.gov/pubmed/31906794
http://dx.doi.org/10.1177/1457496919897004
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