Bali P, Toussaint ND, Tiong MK, et al. - Parathyroidectomy for severe and refractory secondary hyperparathyroidism (SHPT) is commonly followed by significant fluctuations in serum calcium levels in patients with chronic kidney disease (CKD), however, the present cohort experienced lower long-term morbidity and mortality than described in previous reports. This highlights that in a carefully selected cohort, parathyroidectomy can be safely performed for severe SHPT refractory to medical treatment.

• Researchers assessed 129 patients (mean age 50.7 ± 15 years, 109 (85%) on dialysis) undergoing parathyroidectomy for SHPT during the 10-year study period.

• Significant immediate post operative complications occurred in 6%, requiring admission to the intensive care unit or return to theatre.

• Hospital readmission was required in 19% within the first 6 months.

• At least one episode of hypercalcemia (corrected calcium > 2.6 mmol/L) or hypocalcemia (corrected calcium < 2.1 mmol/L) occurred in 78% and 80%, respectively, within 12 months post parathyroidectomy.

• Over a 12-month period, 5% died, and 6% experienced a major cardiovascular event.