Abstract: 【Abstract】 Objective To explore the changes and related factors of serum calcium and phosphorus levels after total parathyroidectomy (TPTX) in maintenance hemodialysis (MHD) patients.  Methods A total of 30 MHD cases treated with TPTX were included in this study. Their total dosage of element calcium supplement within 10 days, serum intact parathyroid hormone (iPTH), serum alkaline phosphatase (ALP), serum calcium and phosphorus were measured before TPTX and after TPTX for 1, 4 and 7 days. Additionally, the volume of resected parathyroid was measured in 16 cases.  Results The pre-operative serum iPTH and ALP correlated positively with total dose of element calcium supplemented within 10 days after the operation (r=0.614, P＜0.001 and r=0.385, P=0.036, respectively) and resected parathyroid volume (confirmed by pathological examination) (r=0.527, P=0.036 and r=0.799, P＜0.001, respectively), and correlated negatively with post-operative serum calcium measured at every time point. After TPTX, serum calcium and phosphorus decreased gradually, and significantly decreased at 7th day (P＜0.05). Conclusion After TPTX, serum calcium and phosphorus decreased gradually. The pre-operative serum iPTH and ALP correlated negatively to post-operative serum calcium, and positively to the total dose of element calcium supplemented after TPTX.

Key words: Maintenance hemodialysis, Total parathyroidectomy, Forearm parathyroid autograft, Calcium, Phosphorus