Postoperative variations of bone turnover markers in uremic patients with secondary hyperparathyroidism after parathyroidectomy
10.3760/cma.j.issn.1001-7097.2017.10.005
- VernacularTitle:尿毒症继发甲状旁腺功能亢进症患者甲状旁腺切除术后骨转换标志物的短期变化
- Author:
Guang YANG
1
;
Ningning WANG
;
Yifei GE
;
Xiaoming ZHA
;
Huijuan MAO
;
Bo ZHANG
;
Bin SUN
;
Xiangbao YU
;
Ming ZENG
;
Changying XING
Author Information
1. 210029,南京医科大学第一附属医院 江苏省人民医院肾内科
- Keywords:
Hyperparathyroidism;
secondary;
Parathyroidectomy;
Osteoblast;
Osteoclast;
Chronic kidney disease-minerals and bone disorder
- From:
Chinese Journal of Nephrology
2017;33(10):750-756
- CountryChina
- Language:Chinese
-
Abstract:
Objective To study shortdated postoperative variation characteristics of bone turnover markers (BTMs) in uremic patients with secondary hyperparathyroidism (SHPT) underwent parathyroidectomy (PTX). Methods A total of 19 uremic patients with SHPT underwent successful PTX, hospitalized in the Department of Nephrology, The First Affiliated Hospital of Nanjing Medical University from January 2017 to April 2017, were enrolled in the study. The operative model for all enrolled patients was total parathyroidectomy with forearm autotransplantation. The baseline epidemiological and clinical data before PTX and the levels of serum intact parathyroid hormone (iPTH) and serum BTMs after PTX (in the 1st, 3rd and 7th postoperative day) were collected. The correlations between serum iPTH and serum BTMs before PTX and the trend analysis of serum BTMs after PTX were studied. Results The levels of serum iPTH, serum alkaline phosphatase (ALP), serum typeⅠcollagen cross-linked C-telopeptides (CTX) and serum tartrate-resistant acid phosphatase 5b (TRACP-5b) before PTX were increased, in turn, (1512.4±612.0) ng/L, 267.4(153.1, 424.2) U/L, (5.78±1.15)μg/L and (8.79 ± 4.61) IU/L. Positive correlations between ALP and iPTH (r=0.577, P=0.010), TRACP-5b and iPTH (r=0.640, P=0.003), and ALP and TRACP-5b (r=0.698, P=0.001) were found. The serum levels of ALP increased, while the serum levels of CTX and TRACP-5b decreased within 7 days after PTX. Conclusions Renal osteodystrophy (ROD) with high bone turnover rate is common in uremic patients with severe SHPT. The activities of osteoblast and osteoclast are up-regulated in coupling with positive correlations to serum levels of iPTH. Increased activities of osteoblast and decreased activities of osteoclast were found shortdated postoperatively.
