Abstract: 【Abstract】Objective This study aimed to evaluate whether the total parathyroidectomy with auto-transplantation can improve clinical symptoms and quality of life in maintenance hemodialysis (MHD) patients with refractory secondary hyperparathyroidism (SHPT). Methods A total of 80 patients with refractory SHPT experienced total parathyroidectomy with auto-transplantation (PTX+AT) were recruited in this study. Parathyroidectomy assessment of symptoms (PAS) scores and KDQOL-36 questionnaire were used to assess clinical symptoms and quality of life before the surgery and after the surgery for 12 months. Results After
PTX +AT surgery for one year, serum calcium (t=6.732, P=0.003), phosphate (t=10.454, P=0.004), Ca × P (t=12.962, P＜0.001), intact parathyroid hormone (t=24.941, P＜0.001) decreased, as compared with those before PTX + AT surgery. The PAS total score decreased (618.130 ± 196.371 to 336.501 ± 91.332, t=11.791, P=0.001) and the total score of quality of life increased (51.760±13.671 to 78.252±9.901, t=18.831,P＜0.001). Conclusion PTX+AT can effectively improve clinical symptoms and quality of life in MHD patients with refractory SHPT.

Key words: Secondary hyperparathyroidism, Parathyroidectomy, Quality of life, Hemodialysis