Hiperparatiroidismo autónomo en paciente renal crónico estadio 3: valoración clínica a propósito de un caso

Primary –or autonomous– hyperparathyroidism is clinically characterized by the presence of non-pharmacological hypercalcemia with increased or inappropriately normal parathyroid hormone (PTH) levels. We hereby report the case of a 55-year-old woman with chronic kidney disease (CKD) stage 3bA3 who was diagnosed with autonomous hyperparathyroidism. We would like to stress that autonomous hyperparathyroidism is a not infrequent development in CKD patients, that its diagnosis is biochemical and that imaging techniques are only useful to localize hyperfunctioning parathyroid tissue but are not essential for diagnosis. We also review the current surgical criteria and therapeutic alternatives. Among these alternatives, medical treatment with cinacalcet probably deserves special consideration in several patient subgroups that are not candidates for surgery.