To assess the effects of parathyroidectomy (TPTX versus TPTX+AT) for Secondary Hyperparathyroidism in chronic renal failure: A Systematic Review and Meta-Analysis

Liu, Miao‐E; Qiu, Nian-Cun; Zha, Siluo; Du, Zhipeng; Wang, Yifan; Wang, Qiang; Chen, Qi; Cen, Xiaoxia; Jiang, Ying; Luo, Qiong; Shan, Cheng-Xiang; Qiu, Ming

doi:10.1016/j.ijsu.2017.06.029

Cited by 41 publications

(47 citation statements)

References 22 publications

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“…Compared to other procedures, it is associated with a lower recurrence rate, but a higher rate of chronic hypocalcemia and adynamic bone disease [1]. In previous studies, the recurrence rate after total parathyroidectomy varied from 1.9% to 23.8% [12,13]. It is not recommended for patients with CKD stage 5D awaiting kidney transplantation, as the control of serum calcium level may be difficult following the transplantation procedure [14].…”

Section: Discussionmentioning

confidence: 99%

“…However, Tominaga et al [16] reported an increasing frequency of autograft excision over time for the treatment of recurrence in 2,260 patients over a period of 29 years-7.5% required removal of the autograft after 5 years, 17.4% after 10 years, and 25.8% after 20 years. Also, some authors have reported difficulty during autograft excision due to the infiltration of implanted parathyroid tissue into the muscular layers [13].…”

Section: Discussionmentioning

confidence: 99%

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Surgical Outcomes of Subtotal Parathyroidectomy for Renal Hyperparathyroidism

Kim

Lee

et al. 2020

Clin Exp Otorhinolaryngol

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Objectives. The aim of this study was to evaluate the effectiveness of subtotal parathyroidectomy for patients with renal hyperparathyroidism.Methods. We studied 25 patients with renal hyperparathyroidism who underwent subtotal parathyroidectomy from October 2002 to October 2017. We analyzed serum intact parathyroid hormone (iPTH), calcium, and inorganic phosphorus levels before and at multiple time points following surgery, and evaluated the surgical outcomes and complications.Results. Of the 25 patients, 13 (52%) were male and 12 (48%) were female, and the mean age was 53.4±9.3 years. The mean duration of dialysis before parathyroidectomy was 156.8±79.5 months. Mean preoperative serum iPTH and calcium levels were 1,199.0±571.3 pg/mL and 10.5±1.0 mg/dL, respectively. At 6 months postoperatively, the mean iPTH and calcium levels decreased to 49.2±47.6 pg/mL (<i>P</i><0.01) and 8.0±1.0 mg/dL (<i>P</i><0.01), respectively. Recurrent hyperparathyroidism occurred in two patients: one subsequently underwent kidney transplantation and the other continued hemodialysis and maintained normal calcium levels. One patient developed postoperative permanent hypoparathyroidism.Conclusion. Subtotal parathyroidectomy is a safe and effective surgical treatment for renal hyperparathyroidism.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Surgical Outcomes of Subtotal Parathyroidectomy for Renal Hyperparathyroidism

Kim

Lee

et al. 2020

Clin Exp Otorhinolaryngol

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“…EPC deficiency and dysfunction may contribute to increased risk of cardiovascular disease (CVD) observed in patients with chronic kidney disease (CKD) [3-6]. Furthermore, EPCs may also be important in the pathogenesis of various kidney disorders including ischemic acute kidney injury (AKI), sepsis, CKD, glomerulonephritis, acute and chronic rejection in patients with renal transplantation (RT).…”

Section: Introductionmentioning

confidence: 99%

Endothelial Progenitor Cells and Kidney Diseases

Özkök

Yildiz

2018

Kidney Blood Press Res

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Endothelial progenitor cells (EPC) are bone marrow derived or tissue-resident cells that play major roles in the maintenance of vascular integrity and repair of endothelial damage. Although EPCs may be capable of directly engrafting and regenerating the endothelium, the most important effects of EPCs seem to be depended on paracrine effects. In recent studies, specific microvesicles and mRNAs have been found to mediate the pro-angiogenic and regenerative effects of EPCs on endothelium. EPC counts have important prognostic implications in cardiovascular diseases (CVD). Uremia and inflammation are associated with lower EPC counts which probably contribute to increased CVD risks in patients with chronic kidney disease. Beneficial effects of the EPC therapies have been shown in studies performed on different models of CVD and kidney diseases such as acute and chronic kidney diseases and glomerulonephritis. However, lack of a clear definition and specific marker of EPCs is the most important problem causing difficulties in interpretation of the results of the studies investigating EPCs.

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“…Chronic renal failure (CRF), a condition frequently attributed to uncontrolled diabetes mellitus and hypertension, has become an economic and public health burden both globally and locally. 1 – 4 Many studies have demonstrated that CRF is often accompanied by increased inflammatory markers, oxidative stress and thyroid function disorders. 5 – 9 In addition, patients with CRF often have nonthyroidal illness that frequently manifests with changes in serum thyroid hormone levels, which is known as euthyroid sick syndrome (ESS).…”

Section: Introductionmentioning

confidence: 99%

The relationship between inflammatory factors, oxidative stress and DIO-1 concentration in patients with chronic renal failure accompanied with or without euthyroid sick syndrome

Qin

et al. 2018

J Int Med Res

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ObjectiveTo investigate the relationship between inflammatory factors, oxidative stress and type 1 deiodinase (DIO-1) concentration in patients with chronic renal failure (CRF) with or without euthyroid sick syndrome (ESS).MethodsThis study recruited patients with CRF and divided them into two groups: group 1 had low free triiodothyronine (FT3) levels; and group 2 had normal FT3 levels. Group 3 consisted of healthy volunteers. Serum levels of interleukin (IL)-6, IL-1β, tumour necrosis factor (TNF)-α, 8-isoprostane and DIO-1 were measured using enzyme-linked immunosorbent assays. Multiple regression analysis was used to analyse correlations between parameters.ResultsSixty patients were enrolled into each group and the groups were comparable in terms of vital signs, white blood cell count, free thyroxine and thyroid stimulating hormone concentrations. The serum DIO-1 concentration was significantly higher in group 2 than in groups 1 and 3. Multivariate regression analysis revealed that the DIO-1 concentration was inversely correlated with the TNF-α concentration.ConclusionsPatients with CRF without ESS showed higher concentrations of DIO-1 than patients with ESS. The DIO-1 concentration was inversely correlated with the TNF-α concentration, which might indicate that the inflammatory response was milder in the patients with CRF without ESS than in those with ESS.

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To assess the effects of parathyroidectomy (TPTX versus TPTX+AT) for Secondary Hyperparathyroidism in chronic renal failure: A Systematic Review and Meta-Analysis

Abstract: The findings indicate that TPTX is superior to TPTX + AT, while referring to the rate of recurrent SHPT. However, this conclusion needs to be tested in large-scale confirmatory trials. TPTX seems to be a feasible alternative therapeutic option for the surgical treatment of refractory SHPT.

Cited by 41 publications

References 22 publications

Surgical Outcomes of Subtotal Parathyroidectomy for Renal Hyperparathyroidism

Surgical Outcomes of Subtotal Parathyroidectomy for Renal Hyperparathyroidism

Endothelial Progenitor Cells and Kidney Diseases

The relationship between inflammatory factors, oxidative stress and DIO-1 concentration in patients with chronic renal failure accompanied with or without euthyroid sick syndrome

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