Observation of the efficacy of parathyroidectomy for secondary hyperparathyroidism in hemodialysis patients: a retrospective study

Abstract Purpose Parathyroidectomy (PTX) is commonly performed as a treatment for secondary hyperparathyroidism (SHPT) in patients with end-stage renal disease (ESRD). We aimed to evaluate the efficacy of PTX in patients with SHPT who underwent hemodialysis. Methods This retrospective study analyzed...

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Main Authors: Wenqiang Qiu, Ge Zhou
Format: Article
Language:English
Published: BMC 2023-08-01
Series:BMC Surgery
Subjects:
Online Access:https://doi.org/10.1186/s12893-023-02143-y
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author Wenqiang Qiu
Ge Zhou
author_facet Wenqiang Qiu
Ge Zhou
author_sort Wenqiang Qiu
collection DOAJ
description Abstract Purpose Parathyroidectomy (PTX) is commonly performed as a treatment for secondary hyperparathyroidism (SHPT) in patients with end-stage renal disease (ESRD). We aimed to evaluate the efficacy of PTX in patients with SHPT who underwent hemodialysis. Methods This retrospective study analyzed the clinical treatment of 80 hemodialysis patients with SHPT who underwent either total PTX with forearm auto transplantation (TPTX + AT) or subtotal parathyroidectomy (SPTX). We compared the changes in biochemical indices before and after surgery as well as the attenuation of intact parathyroid hormone (iPTH) in the TPTX and SPTX groups. We also evaluated clinical symptoms and quality of life using the Visual Analog Scale (VAS) and the Short Form-36 Questionnaire (SF-36) before and at 3, 6, and 12 months after surgery. Results Serum iPTH and serum phosphorus levels decreased significantly after surgery in 80 patients with SHPT (P < 0.05). Within one month of surgery, there was a difference in iPTH levels between the TPTX + AT and SPTH groups, but there was no difference over time. Patients experienced significant improvement in their clinical symptoms of restless leg syndrome, skin itching, bone pain, and joint pain at 1 week post operation (P < 0.001). Quality of life significantly improved after surgery, as assessed by SF-36 scores (P < 0.05). Hypocalcemia was the most common postoperative complication, occurring in 35% of patients. Within the first 12 months post surgery, 5 patients had a recurrence. Conclusion PTX is effective in rapidly reducing iPTH levels, improving calcium and phosphorus metabolism disorders, and enhancing patients’ quality of life by safely and effectively relieving clinical symptoms.
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spelling doaj.art-2dcefbbf5b9c4e46b7d0c4c01f5390152023-11-26T12:11:36ZengBMCBMC Surgery1471-24822023-08-012311810.1186/s12893-023-02143-yObservation of the efficacy of parathyroidectomy for secondary hyperparathyroidism in hemodialysis patients: a retrospective studyWenqiang Qiu0Ge Zhou1Department of General Surgery, Jinzhou Medical University Postgraduate Training Base (Liaoyang Central Hospital)Department of General Surgery, Liaoyang Central HospitalAbstract Purpose Parathyroidectomy (PTX) is commonly performed as a treatment for secondary hyperparathyroidism (SHPT) in patients with end-stage renal disease (ESRD). We aimed to evaluate the efficacy of PTX in patients with SHPT who underwent hemodialysis. Methods This retrospective study analyzed the clinical treatment of 80 hemodialysis patients with SHPT who underwent either total PTX with forearm auto transplantation (TPTX + AT) or subtotal parathyroidectomy (SPTX). We compared the changes in biochemical indices before and after surgery as well as the attenuation of intact parathyroid hormone (iPTH) in the TPTX and SPTX groups. We also evaluated clinical symptoms and quality of life using the Visual Analog Scale (VAS) and the Short Form-36 Questionnaire (SF-36) before and at 3, 6, and 12 months after surgery. Results Serum iPTH and serum phosphorus levels decreased significantly after surgery in 80 patients with SHPT (P < 0.05). Within one month of surgery, there was a difference in iPTH levels between the TPTX + AT and SPTH groups, but there was no difference over time. Patients experienced significant improvement in their clinical symptoms of restless leg syndrome, skin itching, bone pain, and joint pain at 1 week post operation (P < 0.001). Quality of life significantly improved after surgery, as assessed by SF-36 scores (P < 0.05). Hypocalcemia was the most common postoperative complication, occurring in 35% of patients. Within the first 12 months post surgery, 5 patients had a recurrence. Conclusion PTX is effective in rapidly reducing iPTH levels, improving calcium and phosphorus metabolism disorders, and enhancing patients’ quality of life by safely and effectively relieving clinical symptoms.https://doi.org/10.1186/s12893-023-02143-ySecondary hyperparathyroidismHemodialysisParathyroidectomyQuality of life
spellingShingle Wenqiang Qiu
Ge Zhou
Observation of the efficacy of parathyroidectomy for secondary hyperparathyroidism in hemodialysis patients: a retrospective study
BMC Surgery
Secondary hyperparathyroidism
Hemodialysis
Parathyroidectomy
Quality of life
title Observation of the efficacy of parathyroidectomy for secondary hyperparathyroidism in hemodialysis patients: a retrospective study
title_full Observation of the efficacy of parathyroidectomy for secondary hyperparathyroidism in hemodialysis patients: a retrospective study
title_fullStr Observation of the efficacy of parathyroidectomy for secondary hyperparathyroidism in hemodialysis patients: a retrospective study
title_full_unstemmed Observation of the efficacy of parathyroidectomy for secondary hyperparathyroidism in hemodialysis patients: a retrospective study
title_short Observation of the efficacy of parathyroidectomy for secondary hyperparathyroidism in hemodialysis patients: a retrospective study
title_sort observation of the efficacy of parathyroidectomy for secondary hyperparathyroidism in hemodialysis patients a retrospective study
topic Secondary hyperparathyroidism
Hemodialysis
Parathyroidectomy
Quality of life
url https://doi.org/10.1186/s12893-023-02143-y
work_keys_str_mv AT wenqiangqiu observationoftheefficacyofparathyroidectomyforsecondaryhyperparathyroidisminhemodialysispatientsaretrospectivestudy
AT gezhou observationoftheefficacyofparathyroidectomyforsecondaryhyperparathyroidisminhemodialysispatientsaretrospectivestudy