Parathyroidectomy improves quality of life for patients with refractory secondary hyperparathyroidism receiving maintenance dialysis, according to a new Chinese study.
Investigators used a Chinese version of the Kidney Disease Quality of Life 36-item short form survey (KDQOL-36) to measure quality of life in 212 patients (191 on hemodialysis and 21 on peritoneal dialysis) before and after total parathyroidectomy with forearm autotransplantation (PTx+AT).
Parameters of chronic kidney disease-mineral bone disease, including calcium, phosphate, alkaline phosphatase, and intact parathyroid hormone, significantly decreased after surgery. Nutritional parameters, such as serum albumin, significantly increased after PTx+AT.
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All KDQOL-36 domain scale scores improved after PTx+AT, Jin-Bor Chen, MD, of Kaohsiung Chang Gung Memorial Hospital, Kaohsiung City, Taiwan, and colleagues reported in the International Journal of General Medicine. The physical component score significantly improved from a baseline of 34 to 46 after surgery and the mental component score from 47 to 52. Summary scores for the symptoms and problems of kidney disease significantly increased from 69 to 87. Pruritus, dry skin, cramps, and bone pain particularly improved. Likewise, scores for the burden of kidney disease significantly rose from 12 to 22 and the effects of kidney disease from 70 to 76. Results appeared consistent when the investigators examined time since PTx (0-2 years, 2-5 years, and 5 or more years).
“Although our results need to be further validated by screening tools, we expect PTX to be a potential management regimen for medically refractory secondary HPT in dialysis patients,” Dr Chen’s team concluded.
Reference
Wang L, Xin MH, Ma Y, et al. Effect of parathyroidectomy on quality of life among patients undergoing dialysis. Int J Gen Med. 15:1185–1192 doi:10.2147/IJGM.S354145
