Abstract
Secondary hyperparathyroidism (SHPT) affects a majority of patients with chronic kidney disease (CKD) in the third and above stages with manifestations of chronic renal failure (CRF), especially in patients undergoing hemodialysis. Despite the temporary effects obtained from taking calcimimetics, there is no significant breakthrough in the treatment of SHPT, and most of the patients require parathyroid surgery (PTS). This review describes the main pathophysiological changes in SHPT, their correction, summarizes the indications for PTS, reflects preoperative preparation, anesthetic management, perioperative intensive care, and possible complications associated with SHPT and CRF. The experience of treating 214 patients with SHPT, 237 PTS (23 in connection with relapse of SHPT), algorithm of examination, preoperative preparation, anesthetic management and perioperative intensive care are presented. In the postoperative period, patients are at risk of severe hypocalcemia and hungry bone syndrome, which require careful monitoring and calcium replenishment.
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