Parathyroidectomy for advanced renal hyperparathyroidim in hemodialysis

Treatment of advanced secondary hyperparathyroidism should be shifted from to avoid progression of bone disease to protection of cardiovascular complications induced by ectopic calcification. Patients who suffer from advanced secondary hyperparathyroidism with uncontrollable hypercalcemia or/and hyperphosphatemia by medical treatment should be referred to surgical treatment at relatively early time. Total parathyroidectomy with forearm autograft is adequate operative procedure especially in patients who require long-term hemodialysis.