title: Role of parathyroidectomy on anemia control and erythropoiesis-stimulating agent need in secondary hyperparathyroidism of chronic kidney disease. A retrospective study in 30 hemodialysis patients.
abstract: BACKGROUND
  Parathyroidectomy (Ptx) ameliorates anemia (A) and reduces postoperative erythropoiesis-stimulating agent (ESA) requirement. The authors retrospectively evaluated the effects of successful Ptx on chronic A and ESA need in 30 2HPT patients.
  
  
  METHODS
  From 2004 to 2009,30 anemic hemodialysis (HD) patients, affected by severe 2HPT, underwent Ptx -15 total parathyroidectomy (TP) and 15 TP + subcutaneous autoimplantation (TPai). Patients were evaluated for iPTH, hemoglobin (Hb) levels, erythrocyte count, hematocrit and erythropoietin dosing before and at 6, and 12 months after surgery.
  
  
  RESULTS
  In every case, Ptx achieved a dramatic reduction of iPTH levels. In 26/30 cases(86.6%) an improvement of Hb levels was observed,and 27/30 (90%) patients did not need postoperative ESA treatment,irrespective of the type of surgical procedure carried out (TP or TPai).
  
  
  CONCLUSIONS
  Successful Ptx for 2HPT of CKD determined a considerable improvement of A,reducing exogenous ESA need.In 2HPT of HD patients A is a secondary indication to surgical treatment,but we propose that this condition should be taken into more careful account, given the high costs of ESA therapy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Conzo
authors.forename: Alessandra
authors.initials: A
authors.lastname: Perna
authors.forename: Cristina
authors.initials: C
authors.lastname: Della Pietra
authors.forename: Daniela
authors.initials: D
authors.lastname: Esposito
authors.forename: Anna
authors.initials: A
authors.lastname: Nunziata
authors.forename: Antonietta
authors.initials: A
authors.lastname: Palazzo
authors.forename: Alessandra
authors.initials: A
authors.lastname: Pizza
authors.forename: Ersilia
authors.initials: E
authors.lastname: Satta
authors.forename: Valerio
authors.initials: V
authors.lastname: Sciascia
authors.forename: Luigi
authors.initials: L
authors.lastname: Santini
mesh_terms: D000740:Anemia / Q000209:etiology / Q000517:prevention & control* / Q000601:surgery*; D004363:Drug Utilization / Q000706:statistics & numerical data; D005260:Female; D006397:Hematinics / Q000627:therapeutic use*; D006801:Humans; D006962:Hyperparathyroidism, Secondary / Q000209:etiology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D016105:Parathyroidectomy; D006435:Renal Dialysis; D051436:Renal Insufficiency, Chronic / Q000209:etiology / Q000601:surgery* / Q000628:therapy; D012189:Retrospective Studies; D013997:Time Factors
chemical_list: D006397:Hematinics