Un estudi liderat per investigadors del grup de Nefrologia de l\u2019Institut d\u2019Investigaci\u00f3 Biom\u00e8dica de Bellvitge (IDIBELL) i l\u2019Hospital Universitari de Bellvitge (HUB), ha comparat els resultats de la cirurgia amb el tractament farmacol\u00f2gic en pacients amb hiperparatiro\u00efdisme terciari, \u00e9s a dir, despr\u00e9s d\u2019un trasplantament renal. Els resultats del treball s\u2019han publicat a la revista de m\u00e9s impacte en Nefrologia, Journal of the American Society of Nephrology.<\/p>\n
Es tracta el primer assaig cl\u00ednic que compara aquest dos tractaments per aquesta malaltia i ha estat finan\u00e7at per Instituto de Salud Carlos III dintre de la convocat\u00f2ria de Projectes d\u2019Investigaci\u00f3 Cl\u00ednica Independent.<\/p>\n
El 50% dels pacients amb un trasplantament de rony\u00f3 presenten hiperparatiro\u00efdisme terciari. Aquesta complicaci\u00f3 implica un exc\u00e9s de calci, hipercalc\u00e8mia provocant empitjorament cardiovascular, p\u00e8rdua de densitat \u00f2ssia, i empitjora la superviv\u00e8ncia de l\u2019\u00f2rgan trasplantat L\u2019estudi s\u2019ha realitzat en 30 pacients. A la meitat se\u2019ls ha extret la gl\u00e0ndula paratiroides i a l\u2019altra meitat se\u2019ls ha tractat amb la medicaci\u00f3 habitual.<\/p>\n
Els investigadors han observat que la cirurgia controla totalment la hipercalc\u00e8mia, normalitza la secreci\u00f3 de la parathormona (PTH) i millora la densitat \u00f2sea. Mentre que el tractament nom\u00e9s controla l\u2019exc\u00e9s de calci en un 67% dels casos, no t\u00e9 cap efecte sobre la PTH i tot i que alenteix el descens de la densitat \u00f2ssia no frena el proc\u00e9s.<\/p>\n
L\u2019investigador principal de l\u2019estudi, Josep Maria Cruzado, ha explicat que \u201csi es compta amb un equip de cirurgia amb experi\u00e8ncia en aquest tipus d\u2019operaci\u00f3, la nostra recomanaci\u00f3 en aquests casos \u00e9s operar perqu\u00e8 resulta positiu tant des del punt vista d\u2019efic\u00e0cia, doncs la cirurgia \u00e9s un tractament curatiu, com des del punt de vista econ\u00f2mic: el cost de la cirurgia equival a 14 mesos de tractament, i el medicament s\u2019ha de prendre de forma cr\u00f2nica i no es pot interrompre\u201d.<\/p>\n
Els resultats d\u2019aquest estudi poder modificar la pr\u00e0ctica cl\u00ednica de l\u2019hiperparatiro\u00efdisme terciari. Cruzado ha explicat tamb\u00e9 que es tracta d\u2019una cirurgia m\u00ednimament invasiva i que implica nom\u00e9s un dia d\u2019ingr\u00e9s hospitalari.<\/p>\n
Aquest estudi ha estat coordinat per Josep M Cruzado del Servei de Nefrologia i Pablo Moreno del Servei de Cirurgia de l\u2019HUB i a m\u00e9s en aquest treball han col\u00b7laborat investigadors del serveis de nefrologia, cirurgia, reumatologia i radiologia del HUB i a m\u00e9s d\u2019investigadors del servei de nefrologia i trasplantament renal de l\u2019Hospital Cl\u00ednic de Barcelona<\/p>\n
Josep M. Cruzado*, Pablo Moreno\u2020, Jos\u00e9 V. Torregrosa\u2021, Omar Taco*, Richard Mast\u00a7, Carmen G\u00f3mez-Vaquero\u2016, Carolina Polo*, Ignacio Revuelta\u2021, Jos\u00e9 Francos\u2020, Joan Torras*, Arantxa Garc\u00eda-Barrasa\u2020, Oriol Bestard* and Josep M. Griny\u00f3*. A Randomized Study Comparing Parathyroidectomy with Cinacalcet for Treating Hypercalcemia in Kidney Allograft Recipients with Hyperparathyroidism. JASN<\/p>\n
December 8, 2015.<\/p>\n
doi:10.1681\/ASN.2015060622<\/p>\n","protected":false},"excerpt":{"rendered":"
Hiperparatiroidisme terciari Refer\u00e8ncia de l\u2019article<\/p>\n","protected":false},"author":6,"featured_media":10821,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"site-sidebar-layout":"no-sidebar","site-content-layout":"page-builder","ast-site-content-layout":"","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","theme-transparent-header-meta":"default","adv-header-id-meta":"","stick-header-meta":"default","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"default","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"ast-content-background-meta":{"desktop":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"footnotes":""},"categories":[1,339],"tags":[],"class_list":["post-8031","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-sin-categorizar","category-nefrologia-i-transplantament-renal"],"publishpress_future_action":{"enabled":false,"date":"2024-12-30 13:21:32","action":"change-status","newStatus":"draft","terms":[],"taxonomy":"category"},"publishpress_future_workflow_manual_trigger":{"enabledWorkflows":[]},"_links":{"self":[{"href":"https:\/\/idibell.cat\/wp-json\/wp\/v2\/posts\/8031","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/idibell.cat\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/idibell.cat\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/idibell.cat\/wp-json\/wp\/v2\/users\/6"}],"replies":[{"embeddable":true,"href":"https:\/\/idibell.cat\/wp-json\/wp\/v2\/comments?post=8031"}],"version-history":[{"count":0,"href":"https:\/\/idibell.cat\/wp-json\/wp\/v2\/posts\/8031\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/idibell.cat\/wp-json\/wp\/v2\/media\/10821"}],"wp:attachment":[{"href":"https:\/\/idibell.cat\/wp-json\/wp\/v2\/media?parent=8031"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/idibell.cat\/wp-json\/wp\/v2\/categories?post=8031"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/idibell.cat\/wp-json\/wp\/v2\/tags?post=8031"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}