Abstract: 【Abstract】Objection To investigate the clinical manifestations and the effect of parathyroidectomy (PTX) in maintenance hemodialysis (MHD) patients with secondary hyperparathyroidism (SHPT). Methods We retrospectivelyreviewed 62 MHD patients treated with PTX cases during the period from September, 2008 to July, 2011. Their average age was 48.1±9.2 years old, and their dialysis age ranged 102.1±31.0 months. Symptoms before and after operation, operation complications, pathological findings of the surgical samples, biochemical parameters, serum iPTH, recurrence of SHPT, and prognosis were analyzed.  Results In the 62 PTX cases, 34 cases (54.8%) were subjected to total parathyroidectomy with autotransplantation, and 28 cases (45.2%) were treated with total parathyroidectomy without autotransplantation. Bone pain and pruritus relieved significantly after operation. Two cases had the early operation complication of transient hoarseness. The most prevalent postoperation complication was hypocalcemia, and 96.8% patients required oral or intravenous calcium supplement. All parathyroid samples showed nodular changes on pathological examination, some samples also accompanied with calcification, bleeding or cystic degeneration. Parathyroid adenoma was found in 3 patients (4.8%), and diffuse proliferation of parathyroid gland in 2 patients (3.2%). Serum iPTH, phosphorus and calcium decreased significantly after the operation (P＜0.05). In the 35 patients followed up after operation for more than one year, second PTX was required in 2 patients. Recurrent hyperparathyroidism was found in 6 patients treated with parathyroidectomy plus autotransplantation, of which 2 patients were diagnosed as graft-dependent recurrence and were cured by removal of the graft, and the other 4 cases were treated orally with active from of vitamin D3. Conclusion PTX is a relatively safe and effective method in the treatment of MHD patients with SHPT.

Key words: Maintenance hemodialysis, Secondary hyperparathyroidism, Parathyroidectomy