{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T16:56:08Z","timestamp":1776272168339,"version":"3.50.1"},"reference-count":33,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2007,12,7]],"date-time":"2007-12-07T00:00:00Z","timestamp":1196985600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2008,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Renal hyperparathyroidism (rHPT) almost inevitably develops in pediatric patients with end\u2010stage chronic kidney disease (CKD) and may require parathyroidectomy (PTX) despite intensified conservative therapy. Long\u2010term duration of uncontrolled rHPT may result in disabling osteodystrophy and vascular calcifications. Only a few reports on children undergoing PTX for rHPT are available and mainly consist of case reports with short follow\u2010up periods. To study this entity, we analyzed the course of 23 pediatic patients who underwent PTX for rHPT.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Twenty\u2010three patients with a mean age of 15 years and who underwent PTX for rHPT between 1986 and 2006 were evaluated. Surgical indications and techniques, specific postoperative management, and follow\u2010up courses are described.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Preoperative mean serum (s\u2010) calcium was 2.7 \u00b1 0.05\u00a0mmol\/L (normal range = 2.2\u20132.7\u00a0mmol\/L); s\u2010phosphate was 1.8 \u00b1 0.1\u00a0mmol\/L (normal range = 0.8\u20131.6\u00a0mmol\/L), and mean intact parathyroid hormone (PTH) level was 1240.1 \u00b1 160.1 pg\/ml (normal range = 11\u201365 pg\/ml). Twenty\u2010one patients underwent initial PTX and two patients underwent reoperative PTX. Total PTX with parathyroid autotransplantation (AT) was performed in 18 patients. In three patients less than four parathyroid glands were identified and no AT was performed consecutively. Postoperatively, no complications with respect to bleeding or vocal cord damage were recorded. The postoperative values of s\u2010calcium, s\u2010phosphate, and PTH decreased to or below normal range (s\u2010calcium = 2.0 \u00b1 0.1\u00a0mmol\/L, s\u2010phosphate = 1.2 \u00b1 0.1\u00a0mmol\/L, PTH = 50.1 \u00b1 11.2 pg\/ml). All 15 children below the age of 15 years required calcium intravenously. Follow\u2010up was obtained in all patients 69.6 \u00b1 11.4\u00a0months after PTX. Bone pain resolved in all previously symptomatic patients. S\u2010calcium was 2.2 \u00b1 0.2\u00a0mmol\/L, s\u2010phosphate was 1.4 \u00b1 0.3\u00a0mmol\/L, and PTH was 90.2 \u00b1 21.5 pg\/ml. No patient required repeated parathyroid autografting, and only one underwent an explantation of his AT six years after initial PTX.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Total PTX with AT in pediatric patients with rHPT is a safe and effective procedure. It should be considered if rHPT is refractory to conservative treatment, in view of the risk of potentially lethal vascular calcifications developing in the majority of adults with childhood onset of CKD.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00268-007-9318-6","type":"journal-article","created":{"date-parts":[[2007,12,6]],"date-time":"2007-12-06T19:57:26Z","timestamp":1196971046000},"page":"801-806","source":"Crossref","is-referenced-by-count":13,"title":["Parathyroidectomy for Renal Hyperparathyroidism in Children and Adolescents"],"prefix":"10.1002","volume":"32","author":[{"given":"Katja","family":"Schlosser","sequence":"first","affiliation":[{"name":"Department of Visceral Thoracic and Vascular Surgery, Philipps\u2010University 35033 Baldingerstrasse Marburg Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Claus P.","family":"Schmitt","sequence":"additional","affiliation":[{"name":"Division of Paediatric Nephrology University Hospital for Paediatric and Adolescent Medicine, University of Heidelberg Im Neuenheimer Feld 153 69120 Heidelberg Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Johanna E.","family":"Bartholomaeus","sequence":"additional","affiliation":[{"name":"Department of Visceral Thoracic and Vascular Surgery, Philipps\u2010University 35033 Baldingerstrasse Marburg Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katrin L.","family":"Suchan","sequence":"additional","affiliation":[{"name":"Department of Surgery University Hospital Mannheim, Faculty for Clinical Medicine Ruprechts\u2010Karls\u2010University Heidelberg Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Markus W.","family":"Buchler","sequence":"additional","affiliation":[{"name":"Department of Surgery University Hospital Im Neuenheimer Feld 110 69120 Heidelberg Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthias","family":"Rothmund","sequence":"additional","affiliation":[{"name":"Department of Visceral Thoracic and Vascular Surgery, Philipps\u2010University 35033 Baldingerstrasse Marburg Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Theresia","family":"Weber","sequence":"additional","affiliation":[{"name":"Department of Surgery University Hospital Im Neuenheimer Feld 110 69120 Heidelberg Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2007,12,7]]},"reference":[{"issue":"5","key":"e_1_2_6_2_2","first-page":"1085","article-title":"Summary of the Annual Report on Dialysis Treatment and Renal Transplantation in Germany for 2005 \/ 2006","volume":"14","author":"Frei U","year":"2006","journal-title":"QuaSi\u2010Niere"},{"key":"e_1_2_6_3_2","doi-asserted-by":"publisher","DOI":"10.1542\/peds.111.4.e382"},{"key":"e_1_2_6_4_2","doi-asserted-by":"publisher","DOI":"10.1055\/s\u20102008\u20101066228"},{"key":"e_1_2_6_5_2","doi-asserted-by":"publisher","DOI":"10.2165\/00148581\u2010200305110\u201000005"},{"key":"e_1_2_6_6_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00467\u2010005\u20102082\u20107"},{"issue":"6","key":"e_1_2_6_7_2","first-page":"417","article-title":"Parathyroidectomy in children with renal failure. Retrospective study of 17 cases","volume":"46","author":"Berard E","year":"1989","journal-title":"Arch Fr Pediatr"},{"key":"e_1_2_6_8_2","unstructured":"National Kidney Foundation(2007)Counahan\u2010Barratt method to calculate GFR in children and adolescents. Available athttp:\/\/www.kidney.org\/professionals\/kdoqi\/gfr_calculatorPed.cfm. 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