Impact of parathyroidectomy on the fibroblast growth factor-23 in hemodialysis patients
10.3760/cma.j.issn.1001-7097.2017.10.006
- VernacularTitle:甲状旁腺切除术对维持性血液透析患者成纤维细胞生长因子23的影响
- Author:
Aizhen HOU
1
;
Tanqi LOU
;
Guanqing XIAO
;
Yu ZHANG
;
Jianli ZHANG
;
Yaozhong KONG
Author Information
1. 佛山市第一人民医院 中山大学附属佛山医院肾内科
- Keywords:
Hyperparathyroidism;
secondary;
Parathyroidectomy;
Renal dialysis;
Fibroblast growth factor 23
- From:
Chinese Journal of Nephrology
2017;33(10):757-762
- CountryChina
- Language:Chinese
-
Abstract:
Objective To study the effcts of total parathyroidectomy with autotransplantation (tPTX+AT) on fibroblast growth factor-23 (FGF-23) in maintenance hemodialysis (MHD) patients with severe secondary hyperparathyroidism (SPTH). Methods Maintenance hemodialysis patients with severe SPTH treated in our hospital from 2014 to 2016 were enrolled and divided into two groups:tPTX+AT group and non-surgical group. Two groups' biochemical indexes and FGF-23 level before and after 6 months treatment were compared. Results A total of 48 patients were included in the study, including 22 in the tPTX+AT group and 26 in the non-surgical group. Age, duration of dialysis, primary disease, rate of hypertension, parathyroid hormone (iPTH), FGF - 23, cholesterol (TCH), triglyceride (TG), albumin (ALB), and hemoglobin (HGB) level showed no significant difference between the two groups (P>0.05); but serum calcium and alkaline phosphatase (ALP) of that tPTX+AT group were significantly higher than those of the non-surgical group (P<0.01). After 6 months the blood iPTH, calcium, phosphorus and the calcium-phosphorus product level of tPTX+AT group were significantly lower than those of non-surgical group (P<0.05). Blood lipids, propagated, HGB, and ALP level had no statistical differences in the two groups (P>0.05); serum FGF-23 progressive declined after 1 week, 1 month, 3 month and 6 month in tPTX+AT patients, and after 6 months, the level of FGF-23 was significantly lower than that of non-surgical patients[1462.9(903.7, 5826.9) ng/L vs 12627.9(5488.9, 16844.4) ng/L, P<0.01]. Conclusion tPTX+AT can significantly alleviate calcium and phosphorus metabolism disorders and in 6 months gradually reduce FGF-23 level in patients receiving MHD.
