Lookup NU author(s): Dr Avinash Sewpaul,
Professor John Sayer,
Dr Suren Kanagasundaram
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Background: Secondary hyperparathyroidism is a common complication of end-stage renal disease often requiring parathyroidectomy. Renal transplant with the restoration of normal renal function often allows resolution of hyperparathyroidism, avoiding the need for parathyroid surgery. However, a proportion of patients with hyperparathyroidism become overtly hypercalcemic after renal transplantation which poses management dilemmas between medical and surgical treatment. Case: We present the case of a 48-year-old man with end-stage renal failure known to have secondary hyperparathyroidism who received a living related renal transplant. Post-operatively he developed prompt hypercalcemia, polyuria, polydipsia and rapid onset intratubular calcification, leading to acute tubular necrosis diagnosed on renal biopsy on Day 7 post transplantation. He underwent surgical parathyroidectomy with resolution of his hypercalcemia and improved renal transplant function. Discussion: This case emphasizes the need for good management of secondary hyperparathyroidism together with close surveillance of PTH in patients awaiting renal transplantation. With good renal transplant function hyperparathyroidism usually resolves. Posttransplant surgical parathyroidectomy should be reserved for severe progressive end organ damage. © 2007 Dustri-Verlag Dr. K. Feistle.
Author(s): Sewpaul A, Sayer JA, Mohamed MAS, Ahmed A, Shaw M, Prabhu VR, Wood K, Jones NA, Talbot D, Kanagasundaram NS
Publication type: Article
Publication status: Published
Journal: Clinical Nephrology
Print publication date: 01/07/2007
ISSN (print): 0301-0430
Publisher: Dustri-Verlag Dr. Karl Feistle