Abstract: Objectives To analyze the relationship between parathyroid hormone (PTH) level and pathological changes in parathyroid of hyperparathyroidism through pathological examination of the surgical samples after parathyroidectomy (PTX). Methods A total of 46 dialysis patients with refractory hyperparathyroidism
and treated with PTX in China-Japan Friendship Hospital during the period from Sep. 2009 to Jan. 2012 were enrolled in this study. They were divided into 3 groups based on iPTH level: group A (iPTH ＜1,000 pg/ml), group B (iPTH 1,000～2,000 pg/ml), and group C (iPTH >2,000 pg/ml). They were also divided
into dialysis age >10 years group and dialysis age <10 years group. Laboratory examinations and pathological findings in the parathyroid surgical samples were compared among the 3 groups. Pathological findings in the parathyroid surgical samples were also compared in patients with different dialysis age. Results Ca, P and dialysis age had no differences (P＞0.05), but iPTH and alkaline phosphatase (ALP) levels were significantly different among the 3 groups (P =0.000 and 0.014, respectively). Group C had the highest mean ALP value, followed by group B and group A. Old hemorrhagic foci, eosinophilic cells, transparent cells, adenoid structure, tissue calcification, and vascular wall calcification were seen in the 3 groups. The rate of calcification in parathyroid gland and vascular wall was 23.1% in patients with dialysis age of <10 years, and was 78.9% in those with dialysis age of >10 years (P=0.000). Conclusion iPTH levels were positively correlated with the level of ALP. Calcification in parathyroid gland and vascular wall was positively correlated with dialysis age. However, iPTH level was unrelated to the pathological changes of hyperparathyroidism in parathyroid.

Key words: secondary hyperparathyroidism, Parathyroid hormone, alkaline phosphatase, dialysis age