title: Early effects of parathyroidectomy on erythropoietin production in secondary hyperparathyroidism.
abstract: BACKGROUND
  Secondary hyperparathyroidism (2-HPT) has an adverse effect on renal anemia and may cause a hyporesponsiveness to recombinant human erythropoietin (rHuEpo) in patients with chronic renal failure. The early effects of parathyroidectomy (PTx) on renal anemia, erythropoietin production, and nutritional state were examined.
  
  
  METHODS
  Twenty-nine patients under hemodialysis therapy received a PTx for 2-HPT. They were prospectively studied regarding hematological parameters, rHuEpo use, plasma erythropoietin levels, and nutritional condition until 12 months after PTx.
  
  
  RESULTS
  The hemoglobin level showed a significant increase from 3 months after PTx (10.2% +/- 1.5% to 11.2% +/- 1.3%; P <0.01), associated with a consistent increase of the reticulocyte count. These changes lasted until 12 months after PTx. The plasma erythropoietin level showed a gradual increase of up to about 5 times the level of the preoperative value, until 12 months after PTx (22.6 +/- 10.1 to 106.3 +/- 112.1 mU/mL; P <0.001). The weekly dose of rHuEpo administration decreased after 3 months. The serum levels of albumin and total protein also significantly and gradually improved until 12 months after PTx.
  
  
  CONCLUSIONS
  PTx caused a significant early improvement in renal anemia in patients with secondary hyperparathyroidism. This effect may be caused by an enhanced erythropoietin production and may also be partially due to the improved nutritional state after PTx.
authors.affiliation: The Kidney Center, Saiseikai Yahata Hospital, Yahata-Higashiku, Kitakyushu, Japan. yasunaga@med.email.ne.jp
authors.forename: Chikao
authors.initials: C
authors.lastname: Yasunaga
authors.forename: Kenzo
authors.initials: K
authors.lastname: Matsuo
authors.forename: Taihei
authors.initials: T
authors.lastname: Yanagida
authors.forename: Syunya
authors.initials: S
authors.lastname: Matsuo
authors.forename: Masahiko
authors.initials: M
authors.lastname: Nakamoto
authors.forename: Tadanobu
authors.initials: T
authors.lastname: Goya
mesh_terms: D000328:Adult; D000368:Aged; D004351:Drug Resistance; D004921:Erythropoietin / Q000097:blood* / Q000627:therapeutic use; D005260:Female; D006801:Humans; D006962:Hyperparathyroidism, Secondary / Q000601:surgery*; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D016105:Parathyroidectomy; D011446:Prospective Studies; D012008:Recurrence; D006435:Renal Dialysis; D012086:Reoperation; D016896:Treatment Outcome; D014511:Uremia / Q000628:therapy
chemical_list: D004921:Erythropoietin