A study of 13 cases of secondary hyperparathyroidism caused by chronic renal failure

Total parathyroidectomy and autotransplantation of parathyroid glands were performed in 13 patients with secondary hyperparathyroidism resulting from chronic renal failure. The rate of preoperative imaging of enlarged parathyroid glands was 48.1% by computed tomography, 61.5% by ultrasonography and 50.0% by 201Tl99mTc subtraction scintigraphy. In addition to parathyroidectomy, removal of the tongue segment of the thymus and resection of the lymph nodes and adipose tissues around the upper trachea and thyroid gland were performed in order to remove supernumerary glands, if any. Four glands were resected in 9 patients, five in 3 and seven 1. Significant correlations were observed between the total weight of resected parathyroid glands and preoperative serum level of the C-terminal segment of parathyroid hormone (r=0.807) and between total weight and preoperative serum level of alkaline phosphatase (r=0.769). Subjective symptoms improved postoperatively in 10 patients, but some symptoms remained in 3 patients.