Increase in bone mineral density after successful parathyroidectomy for tertiary hyperparathyroidism after renal transplantation.

Abstract

Few studies have reported changes of bone mineral density (BMD) after parathyroidectomy in patients with persistent hyperparathyroidism after renal transplantation (3 HPT). We retrospectively analyzed 14 patients who underwent successful parathyroidectomy for 3 HPT and who had available BMD data before and after parathyroidectomy. Median follow-up time was 26 months (IQR: 16.8-40.2). Serum calcium levels decreased significantly after parathyroidectomy (2.32 +/- 0.09 versus 2.66 +/- 0.16 mmol/l; p < 0.01), as did PTH levels (5.1 +/- 3.0 versus 27.8 +/- 23.7 pmol/l; p < 0.01). Nine patients (64%) had a steroid-free immunosuppression at follow-up. Mean increase in BMD was 9.5 +/- 8.0% for the spine and 9.5 +/- 7.9% for the hip (p < 0.01 for both sites). Patients with osteoporosis (T-score <or= 2.5) or osteopenia (T-score <or= 1) before parathyroidectomy had the biggest increase in BMD (10.7 +/- 7.7% in hip BMD and of 12.3 +/- 8.1% in spine BMD). Parathyroidectomy is an efficient treatment of osteoporosis and osteopenia in patients with 3 HPT.