Current status of parathyroidectomy for secondary hyperparathyroidism in Japan

Hyperparathyroidism (HPT) is a common complication in haemodialysis patients, associated with morbidity and sometimes mortality [1]. In the majority of patients with secondary hyperparathyroidism (2HPT), this can be managed by medical treatment but this does not always give adequate control of the parathyroid disorder. Some patients require intervention treatment of the parathyroid glands including parathyroidectomy (PTx) and percutaneous ethanol injection therapy (PEIT). Successful surgical treatment achieves a dramatic drop of the parathyroid hormone (PTH) level, relieves the patient from clinical symptoms and reduces mortality [2]. Surgical indications in 2HPT and the frequency of PTx might be influenced by medical therapy, i.e. vitamin D and vitamin D analogues injection therapy, sevelamer hydrochloride, calcimimetics, etc., and the composition of the haemodialysis patients, i.e. race, gender, age and duration of haemodialysis. In this review the current status of PTx for 2HPT in our country is presented including the experiences from our department.