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10.1186/s12882-018-0900-y http://scihub22266oqcxt.onion/10.1186/s12882-018-0900-y C5948802!5948802 !29751781     free     free     free Warning: file_get_contents(https://eutils.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&id=29751781 &cmd=llinks): Failed to open stream: HTTP request failed! 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Full normalization of severe hypertension after parathryoidectomy - a case report and systematic review |pdf=|usr=}}{{29751781 }} gab.com Text Full normalization of severe hypertension after parathryoidectomy - a case report and systematic review JO: BMC Nephrol http://www.kidney.de/pget.php?&tw=1&pmid=29751781 #FOAvip BACKGROUND: Although the relationship between hyperparathyroidism and hypertension has been described for decades, the role of hyperparathyroidism in hypertension in dialysis is still unclear. Following the case of a severely hypertensive dialysis patient, in which parathyroidectomy (PTX) corrected the metabolic imbalance and normalized blood pressure (BP), we tried to contextualize our observation with a systematic review of the recent literature on the effect of PTX on BP. CASE PRESENTATION: A dialysis patient, aged 19 years at the time of this report, with chronic kidney disease (CKD) from childhood; he was an early-preterm baby with very low birth weight (910 g), and is affected by a so-far unidentified familial nephropathy. He started dialysis in emergency at the age of 17. Except for low-dose Bisoprolol, he refused all chronic medication; hypertension (165-200/90-130 mmHg) did not respond to attainment of dry weight (Kt/V?>?1.7; BNP 70-200 pg/ml pre-dialysis). He underwent subtotal PTX 1 year after dialysis start; after PTX, his blood pressure stabilized in the 100-140/50-80 range, and is normal without treatment 5 months later. CONCLUSION: Our patient has some peculiar features: he is young, has a non-immunologic disease, poor compliance to drug therapy, excellent dialysis efficiency. His lack of compliance allows observing the effect of PTX on BP without pharmacologic interference. The prompt, complete and long-lasting BP normalization led us to systematic review the current literature (Pubmed, Embase, Cochrane Collaboration 2000-2016) retrieving 8 case series (194 cases), and one case report (3 patients). The meta-analysis showed a significant, albeit moderate, improvement in BP after PTX (difference: systolic BP -8.49 (CI 2.21-14.58) mmHg; diastolic BP -4.14 (CI 1.45-6.84) mmHg); analysis is not fully conclusive due to lack of information on anti-hypertensive agents. The 3 cases reported displayed a sharp reduction in BP after PTX. In summary, PTX may have a positive influence on BP control, and may result in complete correction or even hypotension in some patients. The potential clinical relevance of this relationship warrants prospective large-scale studies. Twit Text FOAVip Full normalization of severe hypertension after parathryoidectomy - a case report and systematic review ????BMC Nephrol http://www.kidney.de/pget.php?&tw=1&pmid=29751781 #FOAvip Twit Text # Free Paper on # # # # # LINK http://www.kidney.de/pget.php?&tw=1&pmid=29751781 #FOAvip English Wikipedia <ref>{{Cite pmid|29751781 }}</ref> Full normalization of severe hypertension after parathryoidectomy - a case report and systematic review #MMPMID29751781 Sofronie AC ; Kooij I ; Bursot C ; Santagati G ; Coindre JP ; Piccoli GB BMC Nephrol 2018[May]; 19 (1 ): 112 PMID29751781 show ga BACKGROUND: Although the relationship between hyperparathyroidism and hypertension has been described for decades, the role of hyperparathyroidism in hypertension in dialysis is still unclear. Following the case of a severely hypertensive dialysis patient, in which parathyroidectomy (PTX) corrected the metabolic imbalance and normalized blood pressure (BP), we tried to contextualize our observation with a systematic review of the recent literature on the effect of PTX on BP. CASE PRESENTATION: A dialysis patient, aged 19 years at the time of this report, with chronic kidney disease (CKD) from childhood; he was an early-preterm baby with very low birth weight (910 g), and is affected by a so-far unidentified familial nephropathy. He started dialysis in emergency at the age of 17. Except for low-dose Bisoprolol, he refused all chronic medication; hypertension (165-200/90-130 mmHg) did not respond to attainment of dry weight (Kt/V?>?1.7; BNP 70-200 pg/ml pre-dialysis). He underwent subtotal PTX 1 year after dialysis start; after PTX, his blood pressure stabilized in the 100-140/50-80 range, and is normal without treatment 5 months later. CONCLUSION: Our patient has some peculiar features: he is young, has a non-immunologic disease, poor compliance to drug therapy, excellent dialysis efficiency. His lack of compliance allows observing the effect of PTX on BP without pharmacologic interference. The prompt, complete and long-lasting BP normalization led us to systematic review the current literature (Pubmed, Embase, Cochrane Collaboration 2000-2016) retrieving 8 case series (194 cases), and one case report (3 patients). The meta-analysis showed a significant, albeit moderate, improvement in BP after PTX (difference: systolic BP -8.49 (CI 2.21-14.58) mmHg; diastolic BP -4.14 (CI 1.45-6.84) mmHg); analysis is not fully conclusive due to lack of information on anti-hypertensive agents. The 3 cases reported displayed a sharp reduction in BP after PTX. In summary, PTX may have a positive influence on BP control, and may result in complete correction or even hypotension in some patients. The potential clinical relevance of this relationship warrants prospective large-scale studies. |*Severity of Illness Index [MESH] |Humans [MESH] |Hypertension/complications/*diagnostic imaging/*surgery [MESH] |Hyperthyroidism/complications/diagnostic imaging/surgery [MESH] |Male [MESH] |Parathyroidectomy/*trends [MESH] |Renal Insufficiency, Chronic/complications/diagnostic imaging/surgery [MESH]Full normalization of severe hypertension after parathryoidectomy - a (epmc).pdf DeepDyve Pubget Overpricing