Endocrine Abstracts

JOINT1091

Objective: Secondary hyperparathyroidism (SHPT) is a complication of end stage renal disease. Parathyroidectomy is a surgical treatement option for hyperparathyroidism that is commonly performed. We aim in our study to evaluate the outcomes of PTX as a therapeutic strategy for SHPT in hemodilaysis patients.

Methods: We present a retrospective descriptive and monocentric study involving hemodiaysis patients with SHPT who underwent PTX in our ENT departement.

Results: We present 61 hemodialysis patients with dialysis duration ranging from 1 to 20 years who have SHPT. The mean age is 34 years, the sexe ratio is 1,54 and the most common cause of nephropathy is of indeterminate origin in about 50,81%. 52,46% presented with normocalcemia while 45,9% with hypercalcemia and 1,64% with hypocalcemia. The average level of PTH is 1808 pg/ml [334-3263]. the most frequent symptoms are bone pain in75,4%, pruritis in 32,7%, asthenia and weight loss in24,6%. 59 patients underwent cervical ultrasound that was normal in 52,42% while scintgraphy was performed in 60 patients that was pathologic in 98,33% with focal increased uptake in the 4 glands in 31,66%.87% of patients underwent a 7/8th PTX while 14,7% had a ¾ th PTX,1,63% a total PTX with autotransplantation and 1,63% total PTW without transplantation.85% experienced an hypocalcemia with an average of 1,76 on day 1 post operative and 86,66% presented a decrease of >80% of PTH level. the persistance of SHPT was observed in 8 patients and the recurrence in only 2 patients.

Conclusion: Parathyroidectomy is an effective surgical strategy for patients with SHPT that reduce PTH levels and improves the phosphocalcic metabolism, hence it it boost the quality of life and reduces the handicap index.