Abstract: Abstract Objective To investigate the effect of total parathyroidectomy on patients with shrinking man syndrome undergoing maintenance hemodialysis. Methods 16 patients with shrinking man syndrome undergoing hemodialysis were recruited. Parameters including general status, clinical manifestations, height, biochemical examinations (serum total calcium, inorganic phosphate, intact parathyroid hormone) were collected before and after operation.Results Their body weights increased from 2kg to 10kg and their body height changed little 3 month after operation. Bone malformation was remitted to some degree. Bone pain and skin pruritus were remitted rapidly within one day. Intact parathyroid hormone decreased significantly at 1 week after operation and maintained at low levels 1 month and 3 month after operation(20.4 ± 13.5pg/ml,36.3 ±17.4pg/ml,41.7 ± 23.9pg/ml vs 4120.7 ± 865.4pg/ml,respectively. t=18.95,18.88,18.85,respectively.P＜0.01).Compared with serum calcium levels before operation,those decreased rapidly at 1 week after operation. They were elevated slowly within 3 months after operation. However, compared those before operation, they remained lower levels(2.02 ± 0.19mmol/L, 2.28 ± 0.37 mmol/L,2.20 ±0.21 mmol/L vs 2.71 ± 0.22 mmol/L，respectively.t=9.49,4.00,6.71, respectively. P＜0.01). Compared with serum phosphate levels before operation, those after operation decreased rapidly at 1 week and maintained at normal levels 1 month and 3 month after operation (1.05 ± 0.21mmol/L, 1.08 ± 0.24mmol/L, 1.25 ± 0.31mmol/L vs 2.39 ± 0.29mmol/L, respectively. t=14.97,13.92,10.74, respectively. P＜0.01). Conclusions Total parathyroidectomy may be a effective and safely method on shrinking man syndrome in maintenance hemodialysis patients.

Key words: Shrinking man syndrome, Secondary hyperparathyroidism, total parathyroidectomy