Aim: Renal hyperparathyroidism is one of the most common complications in patients with end-stage renal disease and is often resistant to medical treatment. Surgical treatment remains the only definitive option in cases resistant to pharmacological management.Method: We retrospectively reviewed 480 patients who underwent parathyroid surgery between June 2020 and June 2025. Among them, 26 had renal hyperparathyroidism, and after applying exclusion criteria, 14 patients were included in the final analysis. Demographics, surgical strategies, perioperative biochemical data, complications, and follow-up outcomes were assessed.Results: The study population consisted of 14 patients, including 10 males and 4 females. Patient age ranged from 23 to 61 years, dialysis duration ranged from 2 to 21 years, and length of hospital stay ranged from 3 to 28 days. Surgical approaches included subtotal parathyroidectomy (n=5), total parathyroidectomy (n=4), and purge parathyroidectomy (n=5). Preoperatively, parathyroid hormone levels were markedly elevated and showed a substantial postoperative decline, accompanied by improvements in serum calcium and phosphorus levels. Recurrent laryngeal nerve palsy and disease recurrence were observed in none of the patients with long-term follow-up. Postoperative hypocalcemia requiring intravenous calcium therapy was observed in 5 patients, three of whom had undergone purge parathyroidectomy and two total parathyroidectomy. Conclusion: In this retrospective series, parathyroidectomy was associated with marked biochemical improvement in patients with renal hyperparathyroidism refractory to medical management. Surgical approaches were applied according to patient-specific clinical characteristics and intraoperative findings.
Akbulut et al. (Fri,) studied this question.