Comparing Surgery and Medical Management for Persistent Hyperparathyroidism in Adults After Kidney Transplant

What this Trial Is About

This research aims to determine if surgical treatment through subtotal parathyroidectomy offers meaningful benefits compared to conservative management in adults with persistent hyperparathyroidism following kidney transplantation. The study focuses on kidney transplant recipients at least six months post-transplant who continue to have elevated parathyroid hormone and abnormal calcium or phosphate levels. It is designed as an open-label, randomized controlled pilot trial with a 12-month follow-up. Participants are randomly assigned to one of two groups one group undergoes subtotal parathyroidectomy surgery, where most parathyroid tissue is removed but a small portion is preserved, guided by hormone measurements during surgery. The other group receives conservative management involving regular medical follow-up and biochemical monitoring, with treatments such as calcium, vitamin D, and possibly calcimimetics as needed, but no surgery during the study period. Throughout the study, participants will be monitored for changes in bone mineral density at the hip, bone microarchitecture, mineral metabolism markers, bone turnover markers, physical function, muscle strength, quality of life, symptom burden, and kidney graft function. Assessments include biochemical tests and functional evaluations at baseline and after 12 months. Safety and efficacy data will be gathered to inform treatment approaches for this condition.

Parathyroidectomy After Kidney Transplantation