Role of parathyroidectomy on anemia control and erythropoiesis-stimulating agent need in secondary hyperparathyroidism of chronic kidney disease.


COD: 025-32 Categorie: ,

Giovanni Conzo, Alessandra Perna, Cristina Della Pietra, Daniela Esposito, Anna Nunziata, Antonietta Palazzo, Alessandra Pizza, Ersilia Satta, Valerio Sciascia*, Luigi Santini

Ann. Ital. Chir., 2013 84: 25-31
aheadofprint 18 September 2012

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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.


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