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Chinese Journal of Blood Purification ›› 2005, Vol. 4 ›› Issue (8) : 416-419.

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Abstract

Objective To evaluate the effects of parathyroidectomy (PTX) on renal anemia in maintenance hemodialysis (MHD) patients with severe secondary hyper-parathyroidism (SHPT). Methods Twenty-two MHD patients with severe SHPT in Huashan Hospital Dialysis Center were divided into two groups: Eleven patients who underwent total PTX + partial forearm autotransplan- tation (FAT) were enrolled in PTX Group and others were in Non-PTX Group. The iPTH and anemia levels, iron homeostasis, dose of rHuEPO requirement and nutritional state were assessed before and 3, 6, 12 months after PTX + FAT. Results The iPTH level was decreased gradually from 3 months after PTX + FAT. The hemoglobin level and hematocrit showed a significant increase at 12 months after PTX + FAT, associated with a remarkable decreased rHuEPO dose requirement from 6 months after PTX + FAT and a significant difference was also found between two groups at the same time. The serum iron and transferrin saturation levels showed a significant increase at 12 months after PTX + FAT. Concomitantly, the pre-albumin level was gradually higher from 6 months after PTX + FAT. We found no statistically significant differences in CRP, ferritin and the adequacy of dialysis between two groups. Conclusion We conclude that PTX +FAT can improve renal anemia in hemodialysis patients with severe SHPT and greater resistance to rHuEPO therapy. It may be partially due to the improved functional iron deficiency and nutritional state after PTX+FAT.