Parathyroidectomy for Secondary Hyperparathyroidism Improves Outcomes
Parathyroidectomy can correct calcium and phosphorus abnormalities and improve coronary artery calcification, study finds..
Parathyroidectomy (PTX) is an effective way to correct calcium and phosphorus metabolic disorders and decrease aortic calcification in hemodialysis patients with secondary hyperparathyroidism (SHPT), new findings suggest. PTX also can improve arterial stiffness.
Researchers at Air Force General Hospital Beijing, China, studied 20 hemodialysis patients who underwent PTX. They compared calcium, phosphorus, calcium-phosphorus product, and parathyroid hormone (PTH) values and coronary artery calcification (CAC) scores and before and 1 year after the procedure.
All patients had CAC. Mild (score 11–100), moderate (101–399), and severe CAC (400 or more) were present in 1, 11, and 8 patients, respectively. Mean serum calcium levels decreased from 2.44 mmol/L before PTX to 2.15 mmol/L at 1 year post-procedure, a team led by Lide Lun, MD, reported in the Asian Journal of Surgery. Mean serum phosphorus levels decreased from 2.50 to 1.67 mmol/L. Mean serum calcium-phosphorus product decreased from 73.30 to 43.31. Mean intact PTH decreased from 1708.72 ng/L to 110.11 ng/L.
The mean CAC score dropped from 1064.85 before PTX to 403.70 after PTX. The mean brachial-ankle pulse wave velocity decreased from 1577.27 (left) and 1557.83 (right) before PTX to 1160.03 and 1111.23 after PTX, respectively.
Gao Z, Li X, Miao J, Lun L. Impacts of parathyroidectomy on calcium and phosphorus metabolism disorder, arterial calcification and arterial stiffness in haemodialysis patients. Asian J Surg. 2018; published online ahead of print.