Abstract:Secondary hyperparathyroidism (SHPT) often occurs in patients with chronic renal disease (CKD) due to long-term vitamin D deficiency, hypocalcemia and hyperphosphatemia. Almost all CKD patients gradually develop this situation after dialysis. SHPT is the leading cause of death in patients with chronic renal failure. However, drug therapy is gradually tolerated with the development of the disease, leading to the need for surgical treatment. Surgery for SHPT is suitable for patients with refractory SHPT that cannot be controlled by medical drugs and whose parathyroid glands are significantly enlarged on imaging examination. The surgical methods include subtotal parathyroidectomy, total parathyroidectomy with autotransplantation, and total parathyroidectomy. However, the best choice for SHPT remains controversial. Recurrence of SHPT is the most common postoperative complication, Intraoperative imaging of indocyanine green and intraoperative para-thyroid hormone assay can be used to improve the surgery. In a word, SHPT has a high incidence and poor prognosis. There are still many problems in surgical treatment that need further study.
