Abstract
Of 570 patients operated on for hyperparathyroidism, 18 subsequently died (between one day and 12 yr after operation). Pathological findings at necropsy in these patients have been reviewed. Four necropsies on patients with untreated hyperparathyroidism have also been reviewed for comparison. Of these 22 cases, 14 had renal failure at the time of death. This was attributed to the following: nephrocalcinosis 6; chronic glomerulonephritis 4; analgesic nephropathy 1; cystinuria 1; sarcoidosis 1; and polycystic disease 1. Of those with renal failure due to nephrocalcinosis, three had persistent hypercalcaemia after operation; the other three survived only for a short time. There was no evidence of residual nephrocalcinosis producing progressive renal failure if the plasma calcium concentration was corrected. In those with chronic glomerulonephritis, cystinuria, and polycystic disease, the hyperparathyroidism was considered to be tertiary to the renal disease but renal failure was not always present at the time of diagnosis.
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- Britton D. C., Johnston D. A., Thompson M. H., Fleming L. B. The outcome of treatment and changes in presentation of primary hyperparathyroidism. Br J Surg. 1973 Oct;60(10):782–785. doi: 10.1002/bjs.1800601008. [DOI] [PubMed] [Google Scholar]
- Britton D. C., Thompson M. H., Johnston I. D., Fleming L. B. Renal function following parathyroid surgery in primary hyperparathyroidism. Lancet. 1971 Jul 10;2(7715):74–75. doi: 10.1016/s0140-6736(71)92047-2. [DOI] [PubMed] [Google Scholar]
- CRAIG J. M. Observations on the kidney after phosphate loading in the rat. Arch Pathol. 1959 Sep;68:306–315. [PubMed] [Google Scholar]
- Davies D. R., Dent C. E., Watson L. Tertiary hyperparathyroidism. Br Med J. 1968 Aug 17;3(5615):395–399. doi: 10.1136/bmj.3.5615.395. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Dudley F. J., Blackburn C. R. Extraskeletal calcification complicating oral neutral-phosphate therapy. Lancet. 1970 Sep 26;2(7674):628–630. doi: 10.1016/s0140-6736(70)91398-x. [DOI] [PubMed] [Google Scholar]
- HODGKINSON A. BIOCHEMICAL ASPECTS OF PRIMARY HYPERPARATHYROIDISM: AN ANALYSIS OF 50 CASES. Clin Sci. 1963 Oct;25:231–242. [PubMed] [Google Scholar]
- Lloyd H. M. Primary hyperparathyroidism: an analysis of the role of the parathyroid tumor. Medicine (Baltimore) 1968 Jan;47(1):53–71. [PubMed] [Google Scholar]
- Smith J. F. Parathyroid adenomas associated with the malabsorption syndrome and chronic renal disease. J Clin Pathol. 1970 May;23(4):362–369. doi: 10.1136/jcp.23.4.362. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Thier S. O. Renal insufficiency and hypercalcemia. Kidney Int. 1978 Aug;14(2):194–200. doi: 10.1038/ki.1978.108. [DOI] [PubMed] [Google Scholar]