Parathyroid surgery in renal failure patients.

The treatment of hyperparathyroidism secondary to renal failure is a complex clinical dilemma. No simple optimal approach to patient selection and stratification for surgical intervention is available at this time. The goals of this publication are to review the pathophysiology of parathyroid gland function in patients with impaired renal function, make recommendations for how to proceed with a parathyroidectomy in these patients, and to provide some guidelines for preoperative and postoperative management.