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

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

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.

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How to Cite
Conzo, Giovanni, et al. “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”. Annali Italiani Di Chirurgia, vol. 84, no. 1, Jan. 2013, pp. 25-31, https://annaliitalianidichirurgia.it/index.php/aic/article/view/973.
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