Parathyroidectomy in Chronic Haemodialysis in the Nephrology and Haemodialysis Department at the University Hospital Center of Point G in Bamako, Mali  

作　　者：Saharé Fongoro Hamadoun Yattara Seydou Sy Magara Samaké Djénèba Diallo Moctar Coulibaly Fatoumata Modjéré Doumbia Djibril Samaké Moustapha Tangara Alkaya Touré Atabième Kodio Nouhoum Coulibaly Saharé Fongoro;Hamadoun Yattara;Seydou Sy;Magara Samaké;Djénèba Diallo;Moctar Coulibaly;Fatoumata Modjéré Doumbia;Djibril Samaké;Moustapha Tangara;Alkaya Touré;Atabième Kodio;Nouhoum Coulibaly(Nephrology and Haemodialysis Department of the University Hospital Centre of Point G, Bamako, Mali;Faculty of Medicine, University of Bamako, Bamako, Mali;Nephrology Unit of the Fousseyni Daou Hospital in Kayes, Kayes, Mali;Nephrology Unit of the Mali Gavardo Hospital in Sébénikoro, Bamako, Mali;ORL Unit, Reference Health Center of the Municipality V Bamako, Bamako, Mali)

机构地区：[1]Nephrology and Haemodialysis Department of the University Hospital Centre of Point G, Bamako, Mali [2]Faculty of Medicine, University of Bamako, Bamako, Mali [3]Nephrology Unit of the Fousseyni Daou Hospital in Kayes, Kayes, Mali [4]Nephrology Unit of the Mali Gavardo Hospital in Sébénikoro, Bamako, Mali [5]ORL Unit, Reference Health Center of the Municipality V Bamako, Bamako, Mali

出　　处：《Open Journal of Nephrology》2020年第2期135-143,共9页肾脏病（英文）

摘　　要：<strong>Introduction:</strong> Secondary hyperparathyroidism is a common complication in chronic hemodialysis patients. It is characterized by hypersecretion of parathormone by the parathyroid glands to maintain phosphocalcium homeostasis in response to hypocalcemia, lowering of 1.25 dihydroxy vitamin D3 and hyperphosphatemia. <strong>Objective:</strong> To analyze the results of parathyroidectomy (PTX) in cases of secondary hyperparathyroidism (HPTS), report the post-operative course and early and late complications. Patients and Methods: We conducted a retrospective study of ten (10) patients with chronic renal failure operated on at the CHU of Point G over a 32-month period, from January 1, 2016 to August 31, 2019. We analyzed the clinical, biological, radiological and histological parameters of the thyroid glands. <strong>Results:</strong> We have collected 33 cases of secondary hyperparathyroidism. Ten (10) patients met the inclusion criteria. They were 45 years old on average, seven (7) women and three (3) men, in dialysis for an average of 6.8 years before parathyroidectomy. Half of the initial kidney disease was of vascular origin (HTA). No cases of diabetic nephropathy were identified. Symptoms were in order of frequency: bone pain (60%), paresthesia (50%), functional impotence of the lower limbs (50%). Radiological signs included demineralisation (5 out of 6 cases) and brown tumour associated with a fracture (1 out of 6 cases). The most frequent indication for parathyroidectomy (100%) was persistence despite treatment of a serum PTH concentration above 1000 pg/ml. Subtotal PTX (7/8) was performed after cervical ultrasound in all patients. Histological analysis of the parathyroid glands showed adenoma (60%) and hyperplasia in 40% of cases. The evolution was marked by a progressive reduction of the parathormone level over twelve (12) months, without achieving normalization. This could be related to sub-dialysis (generator failure with reduction of dialysis time). There were no cases of complications or mo<strong>Introduction:</strong> Secondary hyperparathyroidism is a common complication in chronic hemodialysis patients. It is characterized by hypersecretion of parathormone by the parathyroid glands to maintain phosphocalcium homeostasis in response to hypocalcemia, lowering of 1.25 dihydroxy vitamin D3 and hyperphosphatemia. <strong>Objective:</strong> To analyze the results of parathyroidectomy (PTX) in cases of secondary hyperparathyroidism (HPTS), report the post-operative course and early and late complications. Patients and Methods: We conducted a retrospective study of ten (10) patients with chronic renal failure operated on at the CHU of Point G over a 32-month period, from January 1, 2016 to August 31, 2019. We analyzed the clinical, biological, radiological and histological parameters of the thyroid glands. <strong>Results:</strong> We have collected 33 cases of secondary hyperparathyroidism. Ten (10) patients met the inclusion criteria. They were 45 years old on average, seven (7) women and three (3) men, in dialysis for an average of 6.8 years before parathyroidectomy. Half of the initial kidney disease was of vascular origin (HTA). No cases of diabetic nephropathy were identified. Symptoms were in order of frequency: bone pain (60%), paresthesia (50%), functional impotence of the lower limbs (50%). Radiological signs included demineralisation (5 out of 6 cases) and brown tumour associated with a fracture (1 out of 6 cases). The most frequent indication for parathyroidectomy (100%) was persistence despite treatment of a serum PTH concentration above 1000 pg/ml. Subtotal PTX (7/8) was performed after cervical ultrasound in all patients. Histological analysis of the parathyroid glands showed adenoma (60%) and hyperplasia in 40% of cases. The evolution was marked by a progressive reduction of the parathormone level over twelve (12) months, without achieving normalization. This could be related to sub-dialysis (generator failure with reduction of dialysis time). There were no cases of complications or mo

关 键 词：Chronic Renal Failure Secondary Hyperparathyroidism DIALYSIS PARATHYROIDECTOMY 

分 类 号：R58[医药卫生—内分泌]