Postsurgical Evaluation of Secondary Nephrogenic Hyperparathyroidism
| العنوان: | Postsurgical Evaluation of Secondary Nephrogenic Hyperparathyroidism |
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| المؤلفون: | Xiao-Feng Pei, Zhenpeng Liao, Jiaoping Mi, Haiyu Hong, Yunping Fan |
| المصدر: | Current Medical Science. 39:259-264 |
| بيانات النشر: | Springer Science and Business Media LLC, 2019. |
| سنة النشر: | 2019 |
| مصطلحات موضوعية: | Adult, Male, Parathyroidectomy, medicine.medical_specialty, medicine.medical_treatment, Urology, Transplantation, Autologous, Biochemistry, Subtotal Parathyroidectomy, Parathyroid Glands, Young Adult, Recurrence, Renal Dialysis, Genetics, medicine, Humans, Autologous transplantation, Dialysis, Aged, Retrospective Studies, Postoperative Care, Hyperparathyroidism, business.industry, Middle Aged, Prognosis, medicine.disease, Transplantation, medicine.anatomical_structure, Parathyroid Hormone, Quality of Life, Kidney Failure, Chronic, Female, Hyperparathyroidism, Secondary, Secondary hyperparathyroidism, Parathyroid gland, business |
| الوصف: | Parathyroidectomy is useful for the treatment of secondary hyperparathyroidism (SHPT) caused by chronic renal failure. The following three types of parathyroidectomy can be performed: subtotal parathyroidectomy, total parathyroidectomy and total parathyroidectomy plus autologous transplantation (tPTX+AT). Each of the three types of surgery has advantages and disadvantages. The present study retrospectively analyzed the efficacy of tPTX+AT for the treatment of SHPT over 1 year. Thirty-seven patients who were diagnosed with secondary nephrogenic hyperparathyroidism and treated with tPTX+AT were selected between September 2014 and October 2016 and followed up for 1 year. Their average age was 66.5±46.0 years, and the average time of dialysis was 48.1±8.2 months. The patients' conditions, including the levels of intact parathyroid hormone (iPTH) and bone metabolism, were compared preoperatively and 1 and 7 days and 1, 3, 6 and 12 months after surgery. In addition, the postoperative complications, pathological data, SHPT recurrence and prognosis were examined. The results showed that the postoperative level of ostalgia and cutaneous pruritus significantly decreased in the patients. An inspection of the parathyroid tissues during the operation confirmed the presence of parathyroid gland hyperplasia with no carcinoma detected. Three patients with hoarseness recovered within 1 month, and 1 patient with unilateral recurrent laryngeal nerve injury improved after 6 months of voice training. Compared to the preoperative condition, the postoperative serum iPTH, serum calcium and serum phosphate levels were significantly decreased (P0.001), and these differences remained significant 12 months after surgery. Compared to the preoperative condition, the alkaline phosphatase (ALP) concentration was decreased on postoperative day 1 (P0.05), but no differences were observed on day 7 or at 1 month (P0.05). The ALP levels continuously decreased at 3, 6 and 12 months (P0.01). In conclusion, tPTX+AT significantly improves the quality of life and serum biomarker levels of these patients. The convenient surgical removal of the hyperplastic parathyroid gland for postoperative recurrence supports tPTX+AT as the recommended treatment for relevant patients. |
| تدمد: | 2523-899X 2096-5230 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::8394ad7de15277c5d7b6a3dc908e496d https://doi.org/10.1007/s11596-019-2028-0 |
| حقوق: | CLOSED |
| رقم الأكسشن: | edsair.doi.dedup.....8394ad7de15277c5d7b6a3dc908e496d |
| قاعدة البيانات: | OpenAIRE |
Find this article in full text from Springer Verlag. | تدمد: | 2523899X 20965230 |
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