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Suggest Treatment For Osteoporosis In An Elderly Person
Question: My father is 63 and has been on dialysis for 3 years now due to ESRD. He has had a very high PTH intact level for at least 6 months now (between 800-1000) despite taking Renagel and Sensipar to try and manage it. I have been reading up on hyperparathyroidism and was wondering if he would be a candidate for parathyroid surgery seeing as his medicine is not doing enough? He had some x-rays done of his wrist and elbow which show early osteoporosis and I also hear that parathyroid disease and high pth can cause that too.
Brief Answer:
Please see as below
Detailed Answer:
Hello,
I understand your concern. Parathyroid gland surgery is usually a safe, uncomplicated intervention, during which the surgeon explores all four of the glands in order to identify the one that is acting up and after its removal, the patients returns to normal. In this case, given the age and especially the kidney disease, most doctors prefer to wait until severe hyperparathyroidism syndromes and advanced osteoporosis develop, before deciding to operate.
Anesthesia is a major concern with ESRD and this fact alone will make it hard to find a surgeon who will be willing to perform the intervention.
On the other hand, even though this kind of operation has a high success rate in patients with no other co-existing conditions, due to the delicate location these glands are situated, requires a great deal of experience, supported also by the fact that the success rate of this intervention is directly related to the number of interventions the surgeon has performed. So in case you may decide to go for it, you should be very careful in choosing a doctor.
I personally think, your father is not a candidate for this intervention as the risks outweigh the benefits.
I hope this helps. Let me know if you have further questions.
Wishing you good health and all the best.
Please see as below
Detailed Answer:
Hello,
I understand your concern. Parathyroid gland surgery is usually a safe, uncomplicated intervention, during which the surgeon explores all four of the glands in order to identify the one that is acting up and after its removal, the patients returns to normal. In this case, given the age and especially the kidney disease, most doctors prefer to wait until severe hyperparathyroidism syndromes and advanced osteoporosis develop, before deciding to operate.
Anesthesia is a major concern with ESRD and this fact alone will make it hard to find a surgeon who will be willing to perform the intervention.
On the other hand, even though this kind of operation has a high success rate in patients with no other co-existing conditions, due to the delicate location these glands are situated, requires a great deal of experience, supported also by the fact that the success rate of this intervention is directly related to the number of interventions the surgeon has performed. So in case you may decide to go for it, you should be very careful in choosing a doctor.
I personally think, your father is not a candidate for this intervention as the risks outweigh the benefits.
I hope this helps. Let me know if you have further questions.
Wishing you good health and all the best.
Note: For further queries related to kidney problems and comprehensive renal care, talk to a Nephrologist. Click here to Book a Consultation.
Above answer was peer-reviewed by :
Dr. Nagamani Ng
Answered by
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