Changes in blood pressure and renal function following subtotal parathyroidectomy in renal transplant patients presenting with persistent hypercalcemic hyperparathyroidism.

摘要: The aims of this retrospective study were to assess renal function and blood pressure after subtotal parathyroidectomy (PTx) performed in transplant (RT) patients presenting with persistent hypercalcemic hyperparathyroidism. We identified 34 (group A) from our records who had undergone PTx between 1981 1994. Group A included 18 women 16 men a mean age 45 +/- 12 years time on dialysis therapy 102 59 months. Thirty the received cyclosporine (CsA) or without steroids and/or azathioprine (AZA) remaining 4 conventional i.e. AZA steroids. Twenty-three treated for hypertension 11 normotensive. was 21 within first year following transplantation 13 period. divided into 3 periods: period 1-pre-PTx; 2-the month PTx; 3-six months PTx. Parameters assessed every patient each these periods. Results group compared those observed matched (control) RT B) did not experience secondary associated significant decrease parathyroid hormone (PTH) levels (45 8 pg/ml vs 338 54 pg/ml; p = 0.0002) calcemia (2.32 0.18 mmol/l 2.75 0.15 mmol/l; 0.0003) during 3. However, we increase serum creatinine (124 30 mumol/l 110 25 mumol/l, 0.0016) Nevertheless, an greater than 30% baseline which still persisted six only (23.5%). There more hypertensive latter subgroup (7 out 87.5%) rest (16 26 64.5%). Renal impairment related pre-PTx SBP, DBP, MBP, calcemia, creatinine, CsA whole trough PTH levels. Conversely, observe changes control same During 2 there SBP (134 140 mmHg; 0.046), DBP (81 9 85 0.03) MBP (99.5 10.5 103.5 A. These differences 3, exception although they no longer statistically significant. Following able discontinue (n 4) antihypertensive drugs. In lower group, difference (132.5 17 140.5 0.05). periods group. This shows that hyperparathyroidism are often (68%). Subtotal is but transient MBP. Surprisingly (23.5%), particularly before results could reflect dual effect balance vasodilating effect.