With the increasing knowledge in parathyroidectomy surgery and physiopathology, patients have been able to achieve better quality of life and longevity after surgery. Chronic kidney disease is mostly associated with secondary parathyroidism, nowadays primarily treated with medical therapy and surgery becomes a good option in refractory patients and autonomous PTH production by nodular hyperplasia (terciary hyperparathyroidism). It is still controversy the best timing for parathyroid surgery regarding kidney transplant.

We gathered a pool of 27 patients, submitted to subtotal parathyroidectomy in our Center, throughout 5 years. Of these, 7 patients were submitted to parathyroid surgery without a kidney transplant (no-KT) and 20 patients had already received a KT.

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

Our results seem to favor better outcomes for patients submitted to subtotal parathyroidectomy before KT (no-KT).