Outcomes of renal hyperparathyroidism following parathyroidectomy in kidney replacement therapy patients at a tertiary centre in South Africa: A retrospective cohort study
Journal of the Colleges of Medicine of South Africa
| Field | Value | |
| Title | Outcomes of renal hyperparathyroidism following parathyroidectomy in kidney replacement therapy patients at a tertiary centre in South Africa: A retrospective cohort study | |
| Creator | Sabela, Tholakele Mhlana, Nontembiso Conradie, Wilhelmina Chothia, Mogamat-Yazied | |
| Description | Background: Renal hyperparathyroidism is a frequent complication among patients with kidney failure. Data on outcomes following parathyroidectomy in patients undergoing kidney replacement therapy (KRT) remain limited in South Africa (SA). This study aimed to assess postoperative surgical and biochemical complication rates and disease recurrence.Methods: We conducted a retrospective cohort study of adult KRT patients who underwent parathyroidectomy for renal hyperparathyroidism at Tygerberg Hospital over 7 years. Kaplan-Meier and univariate logistic regression analyses were used to determine predictors of recurrence.Results: Forty-six patients underwent parathyroidectomy. Two-thirds were female with a mean age of 40.7 ± 8.50 years. Preoperative serum calcium and parathyroid hormone (PTH) concentrations were 2.41 ± 0.27 mmol/L and 176.7 (interquartile range [IQR] 124.4–245.1) pmol/L, respectively. Most patients (80%) underwent subtotal parathyroidectomy. The most common postoperative complication was hungry bone syndrome (HBS), which occurred in 98% of patients, and the postoperative total calcium concentration was 1.63 ± 0.28 mmol/L, observed on day 4 or later. Overall, recurrence of renal hyperparathyroidism occurred in 15% of patients. There were no predictors of recurrence on univariate logistic regression.Conclusion: A lower recurrence rate was observed in total parathyroidectomy and a lower hypoparathyroidism rate in subtotal parathyroidectomy (SPTX). Hungry bone syndrome was found to be the most frequent postoperative complication, reflecting more advanced disease at the time of surgery.Contribution: In the future, the focus at Tygerberg Hospital should be on earlier surgical referral considering our limited medical options, and the decision-making regarding the surgical procedure should be discussed in a multidisciplinary team, with a focus on individualised priorities. | |
| Publisher | AOSIS | |
| Date | 2026-02-09 | |
| Identifier | 10.4102/jcmsa.v4i1.316 | |
| Source | Journal of the Colleges of Medicine of South Africa; Vol 4, No 1 (2026); 7 pages 2960-110X 3105-4331 | |
| Language | eng | |
| Relation |
The following web links (URLs) may trigger a file download or direct you to an alternative webpage to gain access to a publication file format of the published article:
https://jcmsa.org.za/index.php/jcmsa/article/view/316/895
https://jcmsa.org.za/index.php/jcmsa/article/view/316/896
https://jcmsa.org.za/index.php/jcmsa/article/view/316/897
https://jcmsa.org.za/index.php/jcmsa/article/view/316/898
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