Abstract: 【Abstract】Objective To evaluate the relationship between parathyroid weight and pre-operative blood biochemical levels, especially pre-operative serum total parathyroid hormone level (iPTH), in patients with refractory secondary hyperparathyroidism (SHPT). Methods Clinical data of the 43 patients with refractory SHPT and undergoing the first parathyroidectomy (PTX) in Sir Run Run Shaw Hospital from January 2018 to December 2019 were retrospectively reviewed. Multivariate linear regression was used to analyze the relationship between the total weight of parathyroid glands and the biochemical levels of corrected serum calcium,
blood phosphorus, alkaline phosphatase (ALP) and iPTH before PTX as well as dialysis age of the patients. The relationship between the weight, volume and maximum diameter of parathyroid gland and the iPTH level was investigated by Spearman’s rank correlation coefficient. Results A total of 169 parathyroid glands were found and resected during operation in the 43 patients. Spearman’s rank correlation showed that parathyroid weight was positively correlated with parathyroid volume (r=0.915, P＜0.001) and maximum length diameter (r=0.778, P＜0.001), but iPTH had no correlation with parathyroid weight (r=0.143, P= 0.361) and volume (r=0.080, P=0.611). Conclusion In patients with refractory SHPT, the pre-operative blood biochemical levels including iPTH may not reflect the actual hyperplasia of parathyroid gland and cannot fully represent the function of parathyroid gland.

Key words: Secondary hyperparathyroidism, Total parathyroidectomy, Parathyroid gland weight, Parathyroid hormone