Changing surgical indications in azotemic secondary hyperparathyroidism.

It would appear that the initial enthusiasm for surgery in azotemic secondary hyperparathyroidism was unsupported by conclusive data, but that a therapeutic alternative recommending surgical abstinence represents an equally extreme position, particularly since the long-term effects of sustained mild hyperparathyroidism are unknown. The proper course at present for the patient's best interests might best be described as selective. Final resolution of conditional therapy in azotemic hyperparathyroidism awaits the completion of objective studies.