Effect of total parathyroidectomy on quality of life in maintenance hemodialysis patients

doi:10.16138/j.1673-6087.2023.05.005

Abstract

Abstract: Objective To observe the effect of total parathyroidectomy(TPTX) on quality of life in maintenance hemodialysis (MHD) patients. Methods The changes of biochemical indicators including serum calcium (Ga), phosphorus (P), intact parathyroid hormone (IPTH), alkaline phosphatase (ALP), hemoglobin (Hb) and albumin (ALB) in 61 patients with secondary hyperparathyroidism (SHPT) before and after operation were retrospectively analyzed. KDQOL-36 scale and SF-36 scale were used to evaluate the quality of life of patients before and 1 year after operation. Results Postoperative symptoms such as fatigue, bone pain and skin itching were significantly improved. Postoperative serum calcium, phosphorus, alkaline phosphatase and IPTH were significantly lower than those before operation, and hemoglobin and albumin were significantly higher than those before operation. The preoperative quality of life scores was low, while the quality of life scores were significantly increased after TPTX. Preoperative kidney disease-related quality of life, general health-related quality of life, and comprehensive quality of life were positively correlated with hemoglobin and albumin, and negatively correlated with age. Nephropathy-related quality of life and comprehensive quality of life were positively correlated with education level. General health-related quality of life was negatively correlated with serum urea nitrogen and phosphorus. Conclusions PTX can significantly improve the clinical indicators and the quality of life in refractory SHPT patients.

Key words: Secondary hyperparathyroidism, Total parathyroidectomy, Quality of life, Kidney disease and quality of life questionnaire, 36-item short-form

CLC Number:

R581

MA Yan, HU Mengyuan, FANG Shifei, WANG Lin. Effect of total parathyroidectomy on quality of life in maintenance hemodialysis patients[J]. Journal of Internal Medicine Concepts & Practice, 2023, 18(05): 334-338.

Figures/Tables 4

References 26

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项目	术前	术后	t/Z
血红蛋白（g/L）	107.62±19.55	120.00（111.50，137.00）	-4.15
钙（mmol/L）	2.53（2.42，2.93）	2.35±0.11	-6.14
磷（mmol/L）	2.41±0.49	1.10（1.00，1.24）	-8.19
IPTH（μg/L）	1 643.00（1 110.35，2 202.25）	97.00（69.40，126.40）	-8.19
碱性磷酸酶（μ/L）	211.00（121.60，527.00）	81.57±19.64	-7.96
白蛋白（g/L）	39.59±4.30	45.00（42.90，47.00）	-7.74

维度	术前（分）	术后（分）	Z	P
肾脏病的症状	58.33（43.75，64.58）	77.08（70.83，85.42）	-8.20	<0.01
肾脏病的影响	40.63（31.25，50.00）	62.50（56.25，71.88）	-8.16	<0.01
肾脏病的负担	6.25（0.00，6.25）	25.00（18.75，31.25）	-7.84	<0.01
生理评分	28.08（24.55，32.24）	41.87（35.53，46.67）	-8.04	<0.01
心理评分	36.54（31.57，43.43）	52.42（47.97，55.03）	-8.14	<0.01
KDTA	35.42（26.74，40.97）	55.90（49.13，61.81）	-8.19	<0.01
SF-12	32.10（28.36，38.06）	46.90±3.77	-8.15	<0.01
综合生活质量	36.47（27.71，39.70）	52.33±5.63	-8.19	<0.01

功能	术前（分）	术后1年（分）	Z
PF	40.00（25.00，55.00）	75.00（60.00，95.00）	-8.20
RP	25.00（0.00，50.00）	75.00（50.00，100.00）	-9.43
BP	22.00（10.00，41.00）	82.00（62.00，100.00）	-8.19
GH	25.00（10.00，,45.00）	72.00（52.00，96.00）	-8.20
VT	25.00（10.00，45.00）	75.00（50.00，95.00）	-8.20
SF	25.00（0.00，62.50）	62.50（50.00，100.00）	-7.65
RE	33.33（0.00，66.67）	66.67（66.67，100.00）	-7.56
MH	40.00（8.00，80.00）	76.00（60.00，96.00）	-7.92

项目	KDTA		SF-12		综合生活质量
项目	r	P	r	P	r	P
年龄	-0.28	0.01	-0.28	0.01	-0.29	0.01
文化程度	0.24	0.02	0.16	0.13	0.23	0.03
透析龄	-0.05	0.64	-0.11	0.32	-0.07	0.52
血红蛋白	0.38	0.00	0.31	0.01	0.37	0.00
尿素氮	-0.11	0.29	-0.22	0.04	-0.15	0.15
肌酐	0.13	0.23	-0.07	0.51	0.01	0.50
钾	-0.18	0.09	-0.20	0.06	-0.20	0.06
钙	-0.21	0.05	-0.07	0.50	-0.17	0.11
磷	-0.14	0.18	-0.22	0.04	-0.18	0.10
IPTH	-0.09	0.42	-0.11	0.33	-0.10	0.37
碱性磷酸酶	0.09	0.39	0.10	0.38	0.10	0.36
白蛋白	0.46	0.00	0.37	0.00	0.45	0.00