Hyperparathyroidism Treatment

Hyperparathyroidism Treatment - after renal transplantation...

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Hyperparathyroidism Treatment Primary: Treatment is usually surgical removal of the gland(s) containing adenomas. Medications include oestrogen replacement therapy in postmenopausal women and bisphosphonates. Bisphosphonates may improve bone turnover. Newer medications termed "calcimimetics" used in secondary hyperparathyroidism are now being used in Primary hyperparathyroidism. Calcimimetics reduce the amount of parathyroid hormone released by the parathyroid glands. They are recommended in patients in whom surgery is inappropriate. Secondary: If the underlying cause of the hypocalcemia can be addressed, the hyperparathyroidism will resolve. In patients with chronic renal failure, treatment consists of dietary restriction of phosphorus, supplements with an active form of vitamin D such as calcitriol, Hectorol, Zemplar(paricalcitol), etc. and phosphate binders which can be divided into calcium-based and non-calcium based. A newer class of medications is calcimimetics. Most patients with hyperparathyroidism secondary to chronic kidney disease will improve
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Unformatted text preview: after renal transplantation, but many will continue to have a degree of residual hyperparathyroidism (tertiary hyperparathyroidism) post-transplant with associated risk of bone loss, etc. Tertiary: The basis of treatment is still prevention in chronic renal failure, starting medication and dietary restrictions long before dialysis treatment is initiated. Cinacalcet has greatly reduced the number of patients who ultimately require surgery for secondary hyperparathyroidism; however, approximately 5% of patients do not respond to medical therapy. If the patient fails to respond to medical treatment, the treatment of choice is surgical removal of three and one half parathyroid glands. Prognosis The prognosis is dependent on the successful treatment of the underlying cause. Prevention As with many conditions, prevention is dependent on early identification of the underlying cause....
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Hyperparathyroidism Treatment - after renal transplantation...

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