title: The effects of parathyroidectomy on nutritional and biochemical status of hemodialysis patients with severe secondary hyperparathyroidism.
abstract: The nutritional and biochemical parameters of 15 chronic hemodialysis (HD) patients with severe secondary hyperparathyroidism who had undergone total parathyroidectomy (PTX), with a forearm implant, were retrospectively studied at 1, 3, 6, and 12 months pre- and post-PTX. The concentrations of serum calcium and phosphorous significantly decreased in the first 6 months post-PTX. The concentration of blood urea nitrogen significantly increased at 6 and 12 months post-PTX. In contrast with control chronic HD patients who had no weight gain after nonparathyroid surgery, there was a progressive weight gain leading to a significantly higher dry weight at 12 months post-PTX. There was no significant change in serum potassium, albumin, cholesterol, transferrin, bicarbonate, hematocrit, normalized protein catabolic rate (nPCR), or erythropoietin dose at any time point post-PTX. The biochemical parameters of the 8 patients who had more than 5% weight gain, during 12 months post-PTX, were not statistically different from the remaining 7 cases who had weight gain less than 5% (or had lost weight) in the same time period. The same was true for 4 patients with weight gain of more than 10% versus the latter group. In conclusion, HD patients with severe secondary hyperparathyroidism are prone to progressive weight gain post-PTX, which reaches significance by the twelfth month. In 53% of the patients, the weight gain is more than 5% above the baseline. The nutritional and biochemical parameters pre-PTX were not helpful in distinguishing those who developed significant weight gain post-PTX.
authors.affiliation: Department of Medicine, Saint Louis University School of Medicine, St Louis, MO, USA.
authors.forename: P
authors.initials: P
authors.lastname: Khajehdehi
authors.forename: M
authors.initials: M
authors.lastname: Ali
authors.forename: F
authors.initials: F
authors.lastname: Al-Gebory
authors.forename: G
authors.initials: G
authors.lastname: Henry
authors.forename: B
authors.initials: B
authors.lastname: Bastani
mesh_terms: D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D015415:Biomarkers / Q000097:blood; D001835:Body Weight / Q000502:physiology; D001847:Bone Diseases / Q000209:etiology*; D005260:Female; D006801:Humans; D006962:Hyperparathyroidism, Secondary / Q000150:complications* / Q000503:physiopathology / Q000601:surgery*; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000503:physiopathology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status / Q000502:physiology; D010280:Parathyroid Glands / Q000637:transplantation; D016105:Parathyroidectomy; D006435:Renal Dialysis; D012189:Retrospective Studies; D014182:Transplantation, Autologous; D016896:Treatment Outcome; D015430:Weight Gain
chemical_list: D015415:Biomarkers