The effect of parathyroidectomy on hematocrit and erythropoietin dose in patients on hemodialysis.
Hyperparathyroidism has been implicated as a cause for resistance to erythropoietin therapy, based on a limited number of studies. The authors retrospectively surveyed the effects of parathyroidectomy on hematocrit and erythropoietin dose in patients with end-stage renal disease. The study group included 10 patients (4 men, 6 women) on long-term hemodialysis, 9 of whom were receiving erythropoietin intravenously during dialysis. Parathyroidectomy resulted in a decrease in mean parathormone levels from 15 times normal preoperatively to 2.3 times normal at follow-up. The hematocrit values increased, and the weekly erythropoietin dose decreased significantly when values 1 month before surgery were compared with those 6 months after surgery. From this, the authors conclude that secondary hyperparathyroidism is a cause of worsening anemia and increased erythropoietin requirements in patients on hemodialysis, and that parathyroidectomy is effective in reversing these abnormalities.
Rault
R
R
Department of Medicine, University of Pittsburgh, Pennsylvania 15213-2500, USA.
Magnone
M
M
D000328:Adult; D000368:Aged; D000740:Anemia / Q000188:drug therapy / Q000209:etiology; D004351:Drug Resistance; D004921:Erythropoietin / Q000008:administration & dosage*; D005260:Female; D006400:Hematocrit; D006801:Humans; D006962:Hyperparathyroidism, Secondary / Q000601:surgery; D008297:Male; D008875:Middle Aged; D016105:Parathyroidectomy; D011994:Recombinant Proteins; D006435:Renal Dialysis / Q000009:adverse effects; D012189:Retrospective Studies
D011994:Recombinant Proteins; D004921:Erythropoietin