title: Bone mineral density 5 years after parathyroidectomy in hemodialysis patients with secondary hyperparathyroidism.
abstract: BACKGROUND
  Whether bone mineral density (BMD) is improved at 5 years after parathyroidectomy (PTx) for secondary hyperparathyroidism (SHPT) remains unknown.
  
  
  OBJECTIVE
  To investigate BMD after PTx by dual energy X-ray absorptiometry (DXA).
  
  
  METHODS
  BMD was measured at the distal 1/3 of the radius (non-shunt side) and at the lumbar supine (L2-L4, lateral view) before and 5 years after PTx in 35 hemodialysis patients who had undergone surgery from April 1994 to May 2004. The data were analyzed retrospectively.
  
  
  RESULTS
  Intact PTH decreased significantly from 1,100 ± 530 (range: 446 - 2,300) pg/ ml before PTx to 75 ± 68 (2 - 251) pg/ml at 5 years after PTx (p < 0.01). Before PTx, the radial BMD and lumbar BMD were both decreased -3.3 ± 1.9 SD and -1.3 ± 2.4 SD compared with the corresponding normal mean T-score, respectively. Radial BMD increased significantly from 0.522 ± 0.113 g/cm2 before PTx to 0.545 ± 0.114 g/cm2 (p = 0.01) at 5 years after PTx, while the T-score improved to -2.8 ± 2.0 SD. In contrast, lumbar BMD showed no significant change between before (0.734 ± 0.202 g/cm2) and 5 years after PTx (0.746 ± 0.199 g/cm2), and neither did the T-score (-1.1 ± 2.3 SD). None of the patients suffered any fractures during follow up.
  
  
  CONCLUSIONS
  These findings indicate that maintaining iPTH at < 300 pg/ml for 5 years after PTx results in an increase of radial BMD in SHPT patients with preoperative BMD levels in the osteoporosis range (below -2.5 SD) according to the WHO, as well as stabilizing lumbar BMD.
authors.affiliation: Nephrology Center, Toranomon Hospital, Tokyo, Japan. masayuki.y@coast.ocn.ne.jp
authors.forename: Masayuki
authors.initials: M
authors.lastname: Yamanouchi
authors.forename: Yoshifumi
authors.initials: Y
authors.lastname: Ubara
authors.forename: Noriko
authors.initials: N
authors.lastname: Hayami
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Suwabe
authors.forename: Rikako
authors.initials: R
authors.lastname: Hiramatsu
authors.forename: Keiichi
authors.initials: K
authors.lastname: Sumida
authors.forename: Eiko
authors.initials: E
authors.lastname: Hasegawa
authors.forename: Junichi
authors.initials: J
authors.lastname: Hoshino
authors.forename: Naoki
authors.initials: N
authors.lastname: Sawa
authors.forename: Kiho
authors.initials: K
authors.lastname: Tanaka
authors.forename: Yuji
authors.initials: Y
authors.lastname: Marui
authors.forename: Michio
authors.initials: M
authors.lastname: Nakamura
authors.forename: Shinji
authors.initials: S
authors.lastname: Tomikawa
authors.forename: Kennmei
authors.initials: K
authors.lastname: Takaichi
mesh_terms: D000328:Adult; D000368:Aged; D015519:Bone Density; D005260:Female; D006801:Humans; D006962:Hyperparathyroidism, Secondary / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D016105:Parathyroidectomy; D006435:Renal Dialysis