Valente-Da-Silva Henyse Gomes, Maya Maria Cristina Araújo, Moreira Annie Seixas
Universidade do Estado do Rio de Janeiro (UERJ), Rio de Janeiro, RJ, Brasil.
Rev Col Bras Cir. 2017 May-Jun;44(3):263-269. doi: 10.1590/0100-69912017003007.
: to evaluate the benefit of parathyroidectomy in patients on hemodialysis, regarding nutritional and biochemical statuses, body composition and the health-related quality of life.
: this is a longitudinal study involving 28 hemodialysis adult patients with severe secondary hyperparathyroidism evaluated before and one year after surgery. Inclusion criteria: parathyroid hormone levels exceeding ten times the upper normal range and end-stage renal disease in hemodialysis program. We used the body mass index to classify the nutritional status and the biodynamics analyzer to evaluate the body composition. Biochemical analysis included markers of lipid and bone metabolism. We assessed quality of life with the SF36 (Short Form Health Survey) questionnaire. All individuals underwent total parathyroidectomy with a forearm implant.
: there were significant gains in body weight (61.7 vs 66.0 kg, p<0.001), body cell mass (22.0 vs 24.5 kg/m2, p=0.05) and quality of life (p=0.001) after surgery. With respect to bone metabolism, intact PTH, calcium, phosphorus and alkaline phosphatase all stabilized and there were improvements in biochemical parameters such as albumin and hemoglobin.
: parathyroidectomy improves hemodialysis patient survival and is associated with weight and bone cell mass gain and improvement in health-related quality of life.
评估甲状旁腺切除术对血液透析患者营养和生化状况、身体成分以及健康相关生活质量的益处。
这是一项纵向研究，纳入了28例严重继发性甲状旁腺功能亢进的成年血液透析患者，在手术前及术后一年进行评估。纳入标准：甲状旁腺激素水平超过正常范围上限的十倍且处于血液透析项目中的终末期肾病患者。我们使用体重指数对营养状况进行分类，并使用生物动力学分析仪评估身体成分。生化分析包括脂质和骨代谢标志物。我们使用SF36（简短健康调查问卷）评估生活质量。所有患者均接受了甲状旁腺全切术并在前臂植入甲状旁腺。
术后体重（61.7 vs 66.0 kg，p<0.001）、身体细胞质量（22.0 vs 24.5 kg/m2，p=0.05）和生活质量（p=0.001）均有显著增加。在骨代谢方面，完整甲状旁腺激素、钙、磷和碱性磷酸酶均趋于稳定，白蛋白和血红蛋白等生化参数也有所改善。
甲状旁腺切除术可提高血液透析患者的生存率，并与体重和骨细胞质量增加以及健康相关生活质量改善相关。
