Injection of Teriparatide to Prevent Hypocalcemia After Parathyroidectomy in Dialysis Patients (TeriCa).
Injection of Teriparatide to Prevent Hypocalcemia After Parathyroidectomy in Dialysis Patients (TeriCa).
This is a pilot randomized controlled trial aimed to evaluate the effect of teriparatide on
 the clinical course of hypocalcemia after parathyroidectomy for secondary hyperparathyroidism
 in dialysis-dependent patients.
Postoperative hypocalcemia is a common complication after parathyroidectomy (PTx) for
 secondary hyperparathyroidism in dialysis-dependent patients. It is known to be associated
 with significant drop of parathyroid hormone (iPTH) level after surgery. Thus, in the present
 study we test the hypothesis that reducing iPTH difference before/after PTx with teriparatide
 injections immediately after surgery may alleviate clinical course of post-PTx hypocalcemia.

 This is a feasible study aimed to determine the sample size for further large-scale trial.
Inclusion Criteria:

 1. Age > 18 years;

 2. Patients with end-stage renal disease (ESRD) receiving hemodialysis or peritoneal
 dialysis treatment > 3 months prior surgery;

 3. Severe secondary hyperparathyroidism defined as iPTH level > 800 pg/ml, followed with
 hypercalcemia and/or hyperphosphatemia; with presence of one or more nodular or
 diffuse parathyroid hyperplasia confirmed with CT;

 4. Performed total parathyroidectomy with autotransplantation of the parathyroid tissue.

 Exclusion Criteria:

 1. Emergency surgery;

 2. Primary hyperparathyroidism as a cause of ESRD;

 3. Scheduled (before surgery) blood transfusion;

 4. Re-operative surgery;

 5. Known allergy to the study drug.

 6. Malignant neoplasms of bone tissue (primary or metastatic).