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Erschienen in: Wiener Medizinische Wochenschrift 7-8/2016

01.05.2016 | übersicht

Therapie des sekundären renalen Hyperparathyreoidismus – aktueller Stellenwert der Parathyreoidektomie

verfasst von: Priv.-Doz. Dr. Emanuel Zitt, Prof. Dr. Karl Lhotta

Erschienen in: Wiener Medizinische Wochenschrift | Ausgabe 7-8/2016

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Zusammenfassung

Die Parathyreoidektomie stellt auch heute noch ein adäquates und effizientes Verfahren zur Therapie des therapierefraktären sekundären Hyperparathyreoidismus (sHPT) dar. Sie ermöglicht abhängig vom angewandten Operationsverfahren die höchste „laborchemische Heilungsrate“ des sHPT. Ob sich diese Verbesserungen auch in einem klinischen Langzeitnutzen hinsichtlich der mit dem sHPT einhergehenden Gefäßverkalkung und erhöhten Risiko für kardiovaskuläre Morbidität und Mortalität sowie Gesamtsterblichkeit niederschlägt, ist offen. Rezente Beobachtungs- und Registerstudien weisen in diese Richtung, der eindeutige Beweis durch prospektive randomisierte kontrollierte Studien steht aber noch aus.
Literatur
1.
Zurück zum Zitat Zitt E, Neyer U. Management of secondary hyperparathyroidism in hemodialysis patients. In: Carpi A, Herausgeber. Progress in hemodialysis – from emergent biotechnology to clinical practice. Rijeka: InTech; 2011. S. 331–48. Zitt E, Neyer U. Management of secondary hyperparathyroidism in hemodialysis patients. In: Carpi A, Herausgeber. Progress in hemodialysis – from emergent biotechnology to clinical practice. Rijeka: InTech; 2011. S. 331–48.
2.
Zurück zum Zitat Block GA, Klassen PS, Lazarus JM, et al. Mineral metabolism, mortality, and morbidity in maintenance hemodialysis. J Am Soc Nephrol. 2004;15(8):2208–18.CrossRefPubMed Block GA, Klassen PS, Lazarus JM, et al. Mineral metabolism, mortality, and morbidity in maintenance hemodialysis. J Am Soc Nephrol. 2004;15(8):2208–18.CrossRefPubMed
3.
Zurück zum Zitat Covic A, Kothawala P, Bernal M, et al. Systematic review of the evidence underlying the association between mineral metabolism disturbances and risk of all-cause mortality, cardiovascular mortality and cardiovascular events in chronic kidney disease. Nephrol Dial Transplant. 2009;24(5):1506–23.CrossRefPubMed Covic A, Kothawala P, Bernal M, et al. Systematic review of the evidence underlying the association between mineral metabolism disturbances and risk of all-cause mortality, cardiovascular mortality and cardiovascular events in chronic kidney disease. Nephrol Dial Transplant. 2009;24(5):1506–23.CrossRefPubMed
4.
Zurück zum Zitat Parfrey PS, Chertow GM, Block GA, et al. The clinical course of treated hyperparathyroidism among patients receiving hemodialysis and the effect of cinacalcet: the EVOLVE trial. J Clin Endocrinol Metab. 2013;98(12):4834–44.CrossRefPubMed Parfrey PS, Chertow GM, Block GA, et al. The clinical course of treated hyperparathyroidism among patients receiving hemodialysis and the effect of cinacalcet: the EVOLVE trial. J Clin Endocrinol Metab. 2013;98(12):4834–44.CrossRefPubMed
5.
Zurück zum Zitat Investigators ET, Chertow GM, Block GA, et al. Effect of cinacalcet on cardiovascular disease in patients undergoing dialysis. N Engl J Med. 2012;367(26):2482–94.CrossRef Investigators ET, Chertow GM, Block GA, et al. Effect of cinacalcet on cardiovascular disease in patients undergoing dialysis. N Engl J Med. 2012;367(26):2482–94.CrossRef
6.
Zurück zum Zitat K/DOQI. K/DOQI clinical practice guidelines for bone metabolism and disease in chronic kidney disease. Am J Kidney Dis. 2003;42(4 Suppl 3):1–201. K/DOQI. K/DOQI clinical practice guidelines for bone metabolism and disease in chronic kidney disease. Am J Kidney Dis. 2003;42(4 Suppl 3):1–201.
7.
Zurück zum Zitat KDIGO. KDIGO clinical practice guideline for the diagnosis, evaluation. prevention, and treatment of chronic kidney disease-mineral and bone disorder (CKD-MBD). Kidney Int Suppl. 2009(113):1–130. KDIGO. KDIGO clinical practice guideline for the diagnosis, evaluation. prevention, and treatment of chronic kidney disease-mineral and bone disorder (CKD-MBD). Kidney Int Suppl. 2009(113):1–130.
8.
Zurück zum Zitat Tominaga Y, Tanaka Y, Sato K, et al. Histopathology, pathophysiology, and indications for surgical treatment of renal hyperparathyroidism. Semin Surg Oncol. 1997;13(2):78–86.CrossRefPubMed Tominaga Y, Tanaka Y, Sato K, et al. Histopathology, pathophysiology, and indications for surgical treatment of renal hyperparathyroidism. Semin Surg Oncol. 1997;13(2):78–86.CrossRefPubMed
9.
Zurück zum Zitat Li S, Chen YW, Peng Y, et al. Trends in parathyroidectomy rates in US hemodialysis patients from 1992 to 2007. Am J Kidney Dis. 2011;57(4):602–11.CrossRefPubMed Li S, Chen YW, Peng Y, et al. Trends in parathyroidectomy rates in US hemodialysis patients from 1992 to 2007. Am J Kidney Dis. 2011;57(4):602–11.CrossRefPubMed
10.
Zurück zum Zitat Tentori F, Wang M, Bieber BA, et al. Recent changes in therapeutic approaches and association with outcomes among patients with secondary hyperparathyroidism on chronic hemodialysis: the DOPPS study. Clin J Am Soc Nephrol. 2015;10(1):98–109.CrossRefPubMedPubMedCentral Tentori F, Wang M, Bieber BA, et al. Recent changes in therapeutic approaches and association with outcomes among patients with secondary hyperparathyroidism on chronic hemodialysis: the DOPPS study. Clin J Am Soc Nephrol. 2015;10(1):98–109.CrossRefPubMedPubMedCentral
11.
Zurück zum Zitat Akaberi S, Clyne N, Sterner G, et al. Temporal trends and risk factors for parathyroidectomy in the Swedish dialysis and transplant population – a nationwide, population-based study 1991–2009. BMC Nephrol. 2014;15:75.CrossRefPubMedPubMedCentral Akaberi S, Clyne N, Sterner G, et al. Temporal trends and risk factors for parathyroidectomy in the Swedish dialysis and transplant population – a nationwide, population-based study 1991–2009. BMC Nephrol. 2014;15:75.CrossRefPubMedPubMedCentral
12.
Zurück zum Zitat Xu D, Yin Y, Hou L, et al. Surgical management of secondary hyperparathyroidism: how to effectively reduce recurrence at the time of primary surgery. J Endocrinol Invest (in press). doi:10.1007/s40618-015-0410-8. Xu D, Yin Y, Hou L, et al. Surgical management of secondary hyperparathyroidism: how to effectively reduce recurrence at the time of primary surgery. J Endocrinol Invest (in press). doi:10.​1007/​s40618-015-0410-8.
13.
Zurück zum Zitat Gagne ER, Urena P, Leite-Silva S, et al. Short- and long-term efficacy of total parathyroidectomy with immediate autografting compared with subtotal parathyroidectomy in hemodialysis patients. J Am Soc Nephrol. 1992;3(4):1008–17.PubMed Gagne ER, Urena P, Leite-Silva S, et al. Short- and long-term efficacy of total parathyroidectomy with immediate autografting compared with subtotal parathyroidectomy in hemodialysis patients. J Am Soc Nephrol. 1992;3(4):1008–17.PubMed
14.
Zurück zum Zitat Gasparri G, Camandona M, Abbona GC, et al. Secondary and tertiary hyperparathyroidism: causes of recurrent disease after 446 parathyroidectomies. Ann Surg. 2001;233(1):65–9.CrossRefPubMedPubMedCentral Gasparri G, Camandona M, Abbona GC, et al. Secondary and tertiary hyperparathyroidism: causes of recurrent disease after 446 parathyroidectomies. Ann Surg. 2001;233(1):65–9.CrossRefPubMedPubMedCentral
15.
Zurück zum Zitat Johnson WJ, McCarthy JT, van Heerden JA, et al. Results of subtotal parathyroidectomy in hemodialysis patients. Am J Med. 1988;84(1):23–32.CrossRefPubMed Johnson WJ, McCarthy JT, van Heerden JA, et al. Results of subtotal parathyroidectomy in hemodialysis patients. Am J Med. 1988;84(1):23–32.CrossRefPubMed
16.
Zurück zum Zitat Neyer U, Hoerandner H, Haid A, et al. Total parathyroidectomy with autotransplantation in renal hyperparathyroidism: low recurrence after intra-operative tissue selection. Nephrol Dial Transplant. 2002;17(4):625–9.CrossRefPubMed Neyer U, Hoerandner H, Haid A, et al. Total parathyroidectomy with autotransplantation in renal hyperparathyroidism: low recurrence after intra-operative tissue selection. Nephrol Dial Transplant. 2002;17(4):625–9.CrossRefPubMed
17.
Zurück zum Zitat Zitt E, Rix M, Urena Torres P, et al. Effectiveness of cinacalcet in patients with recurrent/persistent secondary hyperparathyroidism following parathyroidectomy: results of the ECHO study. Nephrol Dial Transplant. 2011;26(6):1956–61.CrossRefPubMed Zitt E, Rix M, Urena Torres P, et al. Effectiveness of cinacalcet in patients with recurrent/persistent secondary hyperparathyroidism following parathyroidectomy: results of the ECHO study. Nephrol Dial Transplant. 2011;26(6):1956–61.CrossRefPubMed
18.
Zurück zum Zitat Wetmore JB, Liu J, Do TP, et al. Changes in secondary hyperparathyroidism-related biochemical parameters and medication use following parathyroidectomy. Nephrol Dial Transplant. 2016;31:103–11.CrossRefPubMed Wetmore JB, Liu J, Do TP, et al. Changes in secondary hyperparathyroidism-related biochemical parameters and medication use following parathyroidectomy. Nephrol Dial Transplant. 2016;31:103–11.CrossRefPubMed
19.
Zurück zum Zitat Kestenbaum B, Andress DL, Schwartz SM, et al. Survival following parathyroidectomy among United States dialysis patients. Kidney Int. 2004;66(5):2010–6.CrossRefPubMed Kestenbaum B, Andress DL, Schwartz SM, et al. Survival following parathyroidectomy among United States dialysis patients. Kidney Int. 2004;66(5):2010–6.CrossRefPubMed
20.
Zurück zum Zitat Ishani A, Liu J, Wetmore JB, et al. Clinical outcomes after parathyroidectomy in a nationwide cohort of patients on hemodialysis. Clin J Am Soc Nephrol. 2015;10(1):90–7.CrossRefPubMedPubMedCentral Ishani A, Liu J, Wetmore JB, et al. Clinical outcomes after parathyroidectomy in a nationwide cohort of patients on hemodialysis. Clin J Am Soc Nephrol. 2015;10(1):90–7.CrossRefPubMedPubMedCentral
21.
Zurück zum Zitat Komaba H, Taniguchi M, Wada A, et al. Parathyroidectomy and survival among Japanese hemodialysis patients with secondary hyperparathyroidism. Kidney Int. 2015;88(2):350–9.CrossRefPubMed Komaba H, Taniguchi M, Wada A, et al. Parathyroidectomy and survival among Japanese hemodialysis patients with secondary hyperparathyroidism. Kidney Int. 2015;88(2):350–9.CrossRefPubMed
22.
Zurück zum Zitat Ivarsson KM, Akaberi S, Isaksson E, et al. The effect of parathyroidectomy on patient survival in secondary hyperparathyroidism. Nephrol Dial Transplant. 2015;30:2027–33.CrossRefPubMed Ivarsson KM, Akaberi S, Isaksson E, et al. The effect of parathyroidectomy on patient survival in secondary hyperparathyroidism. Nephrol Dial Transplant. 2015;30:2027–33.CrossRefPubMed
23.
Zurück zum Zitat Block GA, Zaun D, Smits G, et al. Cinacalcet hydrochloride treatment significantly improves all-cause and cardiovascular survival in a large cohort of hemodialysis patients. Kidney Int. 2010;78(6):578–89.CrossRefPubMed Block GA, Zaun D, Smits G, et al. Cinacalcet hydrochloride treatment significantly improves all-cause and cardiovascular survival in a large cohort of hemodialysis patients. Kidney Int. 2010;78(6):578–89.CrossRefPubMed
24.
Zurück zum Zitat Cunningham J, Danese M, Olson K, et al. Effects of the calcimimetic cinacalcet HCl on cardiovascular disease, fracture, and health-related quality of life in secondary hyperparathyroidism. Kidney Int. 2005;68(4):1793–800.CrossRefPubMed Cunningham J, Danese M, Olson K, et al. Effects of the calcimimetic cinacalcet HCl on cardiovascular disease, fracture, and health-related quality of life in secondary hyperparathyroidism. Kidney Int. 2005;68(4):1793–800.CrossRefPubMed
25.
Zurück zum Zitat Danese MD, Belozeroff V, Smirnakis K, et al. Consistent control of mineral and bone disorder in incident hemodialysis patients. Clin J Am Soc Nephrol. 2008;3(5):1423–9.CrossRefPubMedPubMedCentral Danese MD, Belozeroff V, Smirnakis K, et al. Consistent control of mineral and bone disorder in incident hemodialysis patients. Clin J Am Soc Nephrol. 2008;3(5):1423–9.CrossRefPubMedPubMedCentral
26.
Zurück zum Zitat Cruzado JM, Moreno P, Torregrosa JV, et al. A randomized study comparing parathyroidectomy with cinacalcet for treating hypercalcemia in kidney allograft recipients with hyperparathyroidism. J Am Soc Nephrol (in press). doi:10.1681/ASN.2015060622. Cruzado JM, Moreno P, Torregrosa JV, et al. A randomized study comparing parathyroidectomy with cinacalcet for treating hypercalcemia in kidney allograft recipients with hyperparathyroidism. J Am Soc Nephrol (in press). doi:10.​1681/​ASN.​2015060622.
27.
Zurück zum Zitat Messa P. Parathyroidectomy and patient survival in CKD patients. Nephrol Dial Transplant. 2015;30:1944–6.CrossRefPubMed Messa P. Parathyroidectomy and patient survival in CKD patients. Nephrol Dial Transplant. 2015;30:1944–6.CrossRefPubMed
Metadaten
Titel
Therapie des sekundären renalen Hyperparathyreoidismus – aktueller Stellenwert der Parathyreoidektomie
verfasst von
Priv.-Doz. Dr. Emanuel Zitt
Prof. Dr. Karl Lhotta
Publikationsdatum
01.05.2016
Verlag
Springer Vienna
Erschienen in
Wiener Medizinische Wochenschrift / Ausgabe 7-8/2016
Print ISSN: 0043-5341
Elektronische ISSN: 1563-258X
DOI
https://doi.org/10.1007/s10354-016-0444-3

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