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Hypoparathyroidism associated with severe mineral bone disease postrenal transplantation, treated successfully with recombinant PTH
Author(s) -
MAHAJAN Ashutosh,
NARAYANAN Mohanram,
JAFFERS Gregory,
CONCEPCION Luis
Publication year - 2009
Publication title -
hemodialysis international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.658
H-Index - 47
eISSN - 1542-4758
pISSN - 1492-7535
DOI - 10.1111/j.1542-4758.2009.00380.x
Subject(s) - medicine , hypoparathyroidism , hyperphosphatemia , parathyroidectomy , secondary hyperparathyroidism , renal osteodystrophy , teriparatide , kidney disease , calcitriol , transplantation , calciphylaxis , bone disease , hyperparathyroidism , kidney transplantation , surgery , parathyroid hormone , hemodialysis , bone mineral , vitamin d and neurology , osteoporosis , disease , calcium
Chronic kidney disease (CKD) is commonly, if not universally, associated with derangements in bone and mineral metabolism, characterized by hyperphosphatemia, low calcitriol levels, and secondary hyperparathyroidism. The spectrum of these disorders is termed renal osteodystrophy or chronic kidney disease‐mineral bone disease complex. Aggressive phosphorus control is the cornerstone of management to prevent debilitating complications. Dietary control, phosphate binders, and administration of active vitamin D analogues is the most common initial therapy. Frequently parathyroidectomy is required to reverse or slow the pathological changes when medical management fails. The most common adverse effect of parathyroidectomy is hypocalcemia. We describe a case report of severe hypocalcemia (secondary to surgical hypoparathyroidism) and “hungry bone syndrome,” treated successfully with teriparatide (Forteo ® ) in a patient who underwent renal transplantation following subtotal parathyroidectomy.