Chronic kidney disease is mostly associated with secondary parathyroidism. Nowadays it is primarily treated with medical therapy. Surgery is still the best treatment in refractory patients and tertiary hyperparathyroidism. It is yet controversy the best timing for parathyroid surgery regarding kidney transplant. Our kidney transplant (KT) center is a national reference for parathyroid surgery. Our aim was to evaluate the patients' biochemical profile when submitted to parathyroid surgery before and after receiving renal transplant.

We gathered a pool of patients, submitted to parathyroidectomy in our Center, throughout 5 years. We also created two subgroups of patients, whether submitted to parathyroid surgery before kidney transplant (no-KT) or after a KT (postKT).

We compared pre and post-surgery biochemical results (PTH, calcium and phosphorus) for both no-KT and postKT groups. In both groups there were striking decreases in PTH (>95%) after surgery. Accordingly, the calcium-phosphate biochemical profile was also further influenced by surgical removal of parathyroid gland.

Besides the limitations of the study, our results seem to favor better biochemical profiles for no-KT subgroup. It is probable that a significant number of patients may beneficiate from parathyroidectomy before getting a kidney transplant, but the timing for surgery is still difficult to understand.