Parathyroidectomy in dialysis patients with secondary hyperparathyroidism, laboratory and clinical assessment

Abstract

Purpose: Patients on dialysis are at high risk for developing secondary hyperparathyroidism. This study explores the effect of parathyroidectomy (PTx) in dialysis patients having secondary hyperparathyroidism with the assessment of the clinical and laboratory outcome. Patients and Methods: A combined retrospective and prospective study of twenty patients with chronic kidney disease (CKD) and secondary hyperparathyroidism who underwent total PTx and autotransplantation in the period from January 2017 to January 2019 after approval from the institutional board of ethics. Results: Of the twenty patients, 17 patients (85%) were symptomatic preoperatively. The most common presentation was generalized bone pain (35%). An early postoperative decrease in the mean serum levels of parathyroid hormone (PTH) and calcium (Ca) level – within 12 h after surgery – was observed. By comparison of the pre- and post-operative laboratory investigations, we found a statistically significant decrease in the value of serum PTH, but there was no statistically significant difference in serum Ca level. Conclusion: Most of our patients improved clinically post-PTx. We recommend PTx for CKD patients with secondary hyperparathyroidism suffering from bone pain, generalized weakness, pathological fractures, and psychological disturbance.