The Efficiency of Parathyroidectomy and the Comparison of the Complications of Surgical Procedures in Dialysis Patients

Abstract

Secondary hyperparathyroidism is the hyperplasia and hyperfunctioning of the parathyroid gland in chronic renal failure. The aim of our study was to evaluate the efficiency and complications of surgical methods for secondary hyperparathyroidism in patients requiring dialysis. Forty-one patients operated for secondary hyperparathyroidism before renal transplantation were retrospectively analysed. The efficiency and complications of types of surgery in relation with age, gender, duration of dialysis, symptoms, laboratory test results before and after surgery were evaluated. Mean duration of dialysis was 6.2 ± 3.98 years. Patient's calcium, phosphorus and parathormone levels before surgery were 9.83 ± 1.25 mg/dl, 5.73 ± 2.15 mg/dl, 1847, 0.02 ± 666.602 pg/ml and, after surgery, were 7.85 ± 1.36 mg/dl, 4.5 ± 1.55 mg/dl, 288.05 ± 404.09 pg/ml. The differences betweeen preoperative and postoperative values were statistically significant (p < 0.05) recognizing the efficiency of surgery. The age of patients, the duration of dialysis and the type of surgery were not significantly effective on this difference (p > 0.05). Fifteen patients had subtotal parathyroidectomy, 25 patients had total parathyroidectomy with autotransplantation and one patient had total parathyroidectomy. The incidence of complications did not differ with age, gender, duration of dialysis and type of surgery (p > 0.05). The type of surgery did not possess difference in the improvement in levels of calcium, phosphorus and parathormone and also in the incidence of complications in secondary hyperparathyroidism. Surgeon's experience and individual patient characteristics seem to be more important in determining the type of surgery.