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Parathyroidectomy in the Treatment of Renal OsteodystrophyCalcium Dynamic Studies
Charles A. Hubay, MD;
David Gonzalez-Barcena, MD;
Leroy Klein, MD, PhD;
Victor Frankel, MD;
Robert E. Eckel, MD;
Olof H. Pearson, MD
AMA Arch Surg. 1970;101(2):181-192.
Abstract
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Calcium balance, radioactive calcium kinetic, and urinary hydroxyproline studies were performed in six patients with renal osteodystrophy before and after treatment with vitamin D in three and after subtotal parathyroidectomy in two. Calcium accretion and resorption rates were increased initially in all six patients, consistent with secondary hyperparathyroidism. Relief of bone pain or healing of bone disease, or both, was obtained after vitamin D therapy in two patients with renal osteomalacia and after subtotal parathyroidectomy in two patients with renal osteitis fibrosa. Calcium accretion and resorption rates remained elevated after vitamin D therapy, reflecting persistent hyperparathyroidism or continued bone healing. Six months after subtotal parathyroidectomy in a patient with severe renal osteitis fibrosa cystica, the calcium resorption rate had declined to below normal and the calcium accretion rate was markedly reduced. This was interpreted as cessation of hyperparathyroidism and continued bone healing.
Author Affiliations
Cleveland
From the departments of surgery and medicine, Case Western Reserve University School of Medicine and University Hospitals of Cleveland, Cleveland.
Footnotes
Accepted for publication April 9, 1970.
Read before the 27th annual meeting of the Central Surgical Association, Detroit, Feb 27, 1970.
Reprint requests to University Hospitals of Cleveland, 2065 Adelbert Rd, Cleveland 44106 (Dr. Hubay).
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