I am on peritoneal dialysis. For several months, I have had high ipth levels although I am taking Sensipar and have eliminated calcitriol and rich calcium foods (as prescribed by my doctor). My nephrologist ordered a CT scan of my neck, and the the results showed that I have three parathyroid adenomas. My question is: If I want to receive a kidney transplant, do I need a parathyroid removal surgery? My actual ipth level is 799, my calcium is 8.7 and phosphorus 4.

The decision to have parathyroid surgery to remove hyperplastic glands is a very complex decision that requires review of your recent trends for the parathyroid hormone (PTH) level, review of your recent laboratory levels of calcium, phosphorus and alkaline phosphatase.  It is not based on one laboratory test for one month.  I suggest that you have a discussion with your nephrologist about the risks and benefits of surgery.  The Sensipar (cinacalcet) that you are taking is also an effective agent in treating secondary hyperparathyroidism for dialysis patients.  If you are awaiting a kidney transplant, this must be factored in to whether surgery or medical treatment is better.  This requires careful consideration between you and your nephrologist.

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