Effect of parathyroidectomy on anemia and cardiac function in uremic patients with secondary hyperparathyroidism
10.3760/cma.j.issn.1001-7097.2018.05.001
- VernacularTitle:甲状旁腺切除对尿毒症继发甲状旁腺功能亢进患者贫血和心功能的影响
- Author:
Ying SHEN
1
,
2
;
Ping ZHANG
;
Hua JIANG
;
Xin LEI
;
Lihui QU
;
Chunping XU
;
Jianghua CHEN
Author Information
1. 310003 杭州,浙江大学医学院附属第一医院肾脏病中心
2. 绍兴市中医院肾内科
- Keywords:
Uremia;
Hyperparathyroidism,secondary;
Parathyroidectomy;
Anemia;
Left ventricular function
- From:
Chinese Journal of Nephrology
2018;34(5):321-326
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the effect of total parathyroidectomy (PTX) with forearm autograft on the anemia and cardiac function in uremic patients with secondary hyperparathyroidism (SHPT).Methods The clinical data of 130 uremic patients who received PTX with forearm autograft in the First Affiliated Hospital of Zhejiang University from October 2010 to December 2015 were retrospectively analyzed.The changes of anemia and echocardiogram before and after operation were compared.According to the presence of left ventricular hypertrophy (LVH) before operation,the patients were divided into LVH group and non-LVH group.Echocardiographic indexes before and one year after operation of the two groups were compared.Results (1) Three months and one year after operation,hemoglobin and hematocrit increased while erythropoietin average usage decreased significantly (P＜0.01).(2) Compared with preoperative period,the dry weight was significantly increased one year after operation,and the cardiac function indexes including left ventricular end diastolic diameter (LVDd),interventricular septum end diastolic thickness (IVSd),left ventricular posterior wall end diastolic thickness (LVPWd),interventricular septum systolic thickness (IVSs),left ventricular systolic diameter (LVDs),left ventricular myocardial mass (LVM),and left ventricular myocardial mass index (LVMI) decreased significantly (P ＜ 0.05).(3) In the non-LVH group,only IVSs decreased one year after operation (P ＜ 0.05).In the LVH group,LVDs,LVDd,LVPWd,LVM,LVMI and IVSs were decreased significantly one year after operation than those in preoperative period (P ＜ 0.05).Conclusions PTX with forearm autograft is an effective treatment for uremic patients with SHPT significantly improving anemia and left ventricular structure and function,especially for patients with ventricular hypertrophy in preoperative.
