| Objective:To evaluate the effect of parathyroidectomy on coronary artery calcification and calcium and phosphate abnormality of end-stage renal disease patients.Method:Thirty maintenance patients who underwent PTX(parathyroidectomy) with severe SHPT(secondary hyperparathyroidism) in our division were enrolled in this study. PTH(parathyroid hormone), serum calcium, phosphate, anemia, CAC(coronary artery calcification) score and blood lipid levels and other clinical datas were recorded before and 6,12 months after PTX. Meanwhile, clinical effects of PTX were also evaluated.Results:Dialysis time, serum phosphate, the product of calcium and phosphate, PTH, C reactive protein, BAP(bone-specific alkaline phosphatase), LDL(low density lipoprotein) were higher in patients with CAC(20 person,66.7%)than patients without CAC(10 persons,33.3%). In the multivariable logistic regression analysis,the dialysis time was one of the independent factors for CAC. Serum calcium and phosphate, the product of calcium and phosphate, PTH, C reactive protein, BAP were decreased gradually after PTX. The hemoglobin level and hematocrit showed a significant increase at 12 months.The systolic, diastolic and mean arterial pressures showed a significant increase at 12 months. Concomitantly, The CAC was gradually lower from 6 months afher PTX. We found no statistically significant differernces in CHOL(cholesterol), LDL, IVST(interventricular septal thickness), LVDd(left ventricular end-diastolic diameter), LVPWd(posterior wall diameter of left ventricle at end-diastolic), LVMI(left ventricular mass index), EF(ejection fraction).Symptoms such as the skin pruritus, bone-arthrosis pain, restless legs syndrome and insomnia were improved significantly.Conclusion:Our study demonstrated PTX can reduce the level of PTH and correct calcium and phosphate abnormality safely and effectively. It can prevent or reverse progression of vascular calcification in appropriate patients. |
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