Abstract: 【Abstract】Objective To observe the impact of parathyroidectomy (PTX) on the progression of coronary artery calcification (CAC) in maintenance hemodialysis (MHD) patients complicated with secondary hyperparathyroidism (SHPT), and to analyze the factors contributing to the progression of CAC. Methods A total of 37 MHD patients were enrolled in this study. Nine of them underwent PTX due to refractory SHPT, and 28 of them without PTX were used as controls.Computed tomographic imaging was performed at baseline and in follow-up period to obtain the changes of CAC score. CAC score, serum calcium, phosphorus and iPTH at baseline and in follow-up period were compared between the two groups. Results In PTX group, serum calcium, phosphorus and iPTH at follow-up period after PTX were 2.1±0.3 mmol/L, 1.3±0.5 mmol/L and 82.1±92.6 mmol/L, respectively, significantly lower than those at baseline (P＜0.05). The general CAC score in follow-up period increased significantly, but the annualized change of CAC score was indifferent between the two groups. Progression of CAC was significantly associated with diabetes and baseline CAC score (P=0.0002 and 0.0001, respectively), but not with serum iPTH. Conclusions PTX improved calcium and phosphorus metabolism, but had no effect on the progression of CAC in MHD patients with SHPT. Diabetes and baseline CAC score may affect the progression of CAC.

Key words: Hemodialysis, Secondary hyperparathyroidism, Parathyroidectomy, Coronary artery calcification
score