Parathyroidectomy improves symptomatology and quality of life in patients with secondary hyperparathyroidism

Cheng, Shih‐Ping; Lee, Jie-Jen; Liu, Tsang-Pai; Yang, Tsen-Long; Chen, Han‐Hsiang; Wu, Chih‐Jen; Liu, Chien‐Liang

doi:10.1016/j.surg.2013.08.013

Cited by 56 publications

(47 citation statements)

References 39 publications

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“…However, the procedure had an important beneficial effect, which can be explained by the reduction of the toxic effects of PTH, causing multiple organ damage and exuberant symptomatology 28 . These improvements validate the indication of parathyroidectomy as early as possible in CKD 29,30 . The present study has some limitations that include the low number of participants, due to the financial difficulties of a public hospital, and the lack of information about the body weight gain after PTx.…”

Section: Discussionsupporting

confidence: 63%

Paratireoidectomia na doença renal crônica: efeitos no ganho de peso e na melhora da qualidade de vida

Valente-Da-Silva

Maya

Moreira

2017

Rev. Col. Bras. Cir.

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RESUMO Objetivo: avaliar o benefício de paratireoidectomia em pacientes submetidos à hemodiálise, em relação ao estado nutricional e bioquímico, composição corporal e a qualidade de vida. Métodos: estudo longitudinal envolvendo 28 adultos em programa de hemodiálise, com hiperparatireoidismo secundário grave, avaliados antes e um ano após a cirurgia. Critérios de inclusão: níveis de paratormônio dez vezes superior ao valor de referencia e doença renal crônica em programa de hemodiálise. O índice de massa corporal foi utilizado para classificação do estado nutricional. A bioimpedância elétrica para avaliação da composição corporal. A análise bioquímica incluiu dosagem de lipídios e marcadores do metabolismo ósseo. A qualidade de vida foi avaliada pelo questionário SF36 (Short Form Health Survey). Todos os pacientes foram submetidos à paratireoidectomia total com implante em antebraço. Resultados: houve ganho significativo de peso corporal (61,7 vs 66,0 kg; p<0,001), da massa celular corporal (22,0 vs 24,5 kg/m2; p=0,05) e da qualidade de vida (p=0,001) após a cirurgia. Com relação ao metabolismo ósseo, PTH intacto, cálcio, fósforo e fosfatase alcalina, se estabilizaram e houve melhora em parâmetros bioquímicos, tais como albumina e hemoglobina. Conclusão: a paratireoidectomia melhora a sobrevida em pacientes de hemodiálise e está associada a aumento de peso, ganho de massa óssea e melhoria na qualidade de vida.

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Section: Discussionsupporting

confidence: 63%

Paratireoidectomia na doença renal crônica: efeitos no ganho de peso e na melhora da qualidade de vida

Valente-Da-Silva

Maya

Moreira

2017

Rev. Col. Bras. Cir.

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“…Differences between the two groups on improving muscle weakness and alleviating pruritus were not statistically significant. Cheng et al [23] study applied a 13 symptoms questionnaire in patients with sHPT. They demonstrated that PTX is associated with marked improvement in all symptoms and in quality of life.…”

Section: Discussionmentioning

confidence: 99%

Survival after parathyroidectomy in chronic hemodialysis patients with severe secondary hyperparathyroidism

Moldovan

Racasan²,

Kacsó

et al. 2015

Int Urol Nephrol

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“…The population of patients with ESRD is very heterogeneous with respect to underlying etiology of kidney failure, age and additional co-morbidities, and this may influence decision making regarding referral and/or consideration of parathyroidectomy. (25, 26) For this reason, sicker patients with a greater degree of co-morbid disease may have not been considered for referral or declined surgical intervention, resulting in an inclusion bias. We cannot tell how many patients with above target KDIGO for calcium, phosphate and/or PTH were not referred for surgical consideration.…”

Section: Discussionmentioning

confidence: 99%

Kidney Disease Improving Global Outcomes guidelines and parathyroidectomy for renal hyperparathyroidism

Oltmann

Madkhali

Sippel

et al. 2015

Journal of Surgical Research

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Introduction Patients with end stage renal disease(ESRD) develop hypocalcemia, resulting in secondary hyperparathyroidism(SHPT). No clear criterions exist to aid in surgical decision making for SHPT. The 2009 Kidney Disease: Improving Global Outcomes(KDIGO) guidelines provide target ranges for serum calcium, phosphate and parathyroid hormone(PTH) levels in patients with ESRD. Parathyroidectomy can help achieve these targets. The study purpose is to examine how parathyroidectomy for SHPT impacts KDIGO targets during immediate and long-term follow-up, and to evaluate KDIGO categorization with receipt of additional surgical intervention. Methods A retrospective review of a prospective parathyroidectomy database was performed. Included patients had SHPT, were on dialysis and underwent parathyroidectomy. Calcium, phosphate and PTH values were classified as below, within, or above KDIGO targets. Results Between 2000 and 2013, 36 patients with SHPT met criteria. Subtotal parathyroidectomy was performed in 89%, total parathyroidectomy in 11%. Follow-up time was 54±7 months. 8 patients(22%) required additional surgery. 28 patients(76%) were alive at last follow-up. At last follow up, patients had phosphate(46%), and PTH(17%) above KDIGO ranges. Factors associated with re-operation were assessed. Patient PTH within or above target immediately post-operative had a higher rate of reoperation(p<0.01). At last follow-up, higher phosphate(p=0.054) and PTH(p<0.001) were associated with higher reoperation rates, but calcium(p=0.33) was not. Conclusions PTH and phosphate levels above KDIGO indices were associated with additional surgical intervention. Many patients had laboratory indices above range at last follow-up, suggesting more patients had persistent or recurrent disease than underwent reoperation. Patients may benefit from more aggressive medical and/or surgical management.

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Parathyroidectomy improves symptomatology and quality of life in patients with secondary hyperparathyroidism

Cited by 56 publications

References 39 publications

Paratireoidectomia na doença renal crônica: efeitos no ganho de peso e na melhora da qualidade de vida

Paratireoidectomia na doença renal crônica: efeitos no ganho de peso e na melhora da qualidade de vida

Survival after parathyroidectomy in chronic hemodialysis patients with severe secondary hyperparathyroidism

Kidney Disease Improving Global Outcomes guidelines and parathyroidectomy for renal hyperparathyroidism

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