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August 1970

Parathyroidectomy in the Treatment of Renal OsteodystrophyCalcium Dynamic Studies

Author Affiliations

From the departments of surgery and medicine, Case Western Reserve University School of Medicine and University Hospitals of Cleveland, Cleveland.

Arch Surg. 1970;101(2):181-192. doi:10.1001/archsurg.1970.01340260085014

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.