[Clinical x-ray criteria for a differential approach to the surgical treatment of uremic osteodystrophy].

To define the criteria for a differential approach to operative treatment of uremic osteodystrophy arising in hemodialysis 51 patients were examined clinically, biochemically and roentgenologically before and after parathyroidectomy. Basing on the X-ray picture, the patients were divided into 3 groups: patients with fibrous osteodystrophy seen at X-ray examination (group 1); patients with fibrous osteodystrophy, osteomalacia in predominance of secondary hyperthyroidism (group 2); patients with osteodystrophy and osteomalacia in predominance of osteomalacia syndrome (group 3); patients with uremic osteodystrophy diagnosed only biochemically. Parathyroidectomy proved most effective in group 1 patients. For group 2 patients it is indicated in a subtotal or partial form in a failure of the conservative treatment. In group 3 patients parathyroidectomy is not recommended to avoid a drastic progress of osteomalacia.