Hyperparathyroidism After Renal Transplantation and Long-Term Hemodialysis

Abstract

Two male patients, 29 and 23 years old, with chronic glomerulonephritis and renal insufficiency were treated with hemodialysis followed by renal transplantation. Rejection appeared rather soon after the transplantations and the transplanted kidneys were extirpated in both cases. Postoperatively long-term hemodialysis was instituted. After the transplantation periods and during the hemodialyses signs of hyperparathyroidism developed, including the presence of hypercalcemia and decreased mineralization of the skeleton. Subtotal parathyroidectomy was performed in both patients. Morphologic examinations showed parathyroid hyperplasia. There were ultra-structural signs of high cellular activity. A prominent feature in the chief cells was the appearance of numerous cytoplasmic dense bodies, seemingly of lysosomal nature. The hyperparathyroidism in the present cases is suggested to be of autonomous type and the hemodialyses and possibly the transplantations are believed to play a role in the development of the parathyroid disease.