Bures Claudia, Skachko Tatjana, Dobrindt Eva M, Pratschke Johann, Uluk Deniz, Mogl Martina T
Department of Surgery, Campus Charité Mitte/Campus Virchow-Klinikum, Charité, Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.
Visc Med. 2020 Feb;36(1):34-40. doi: 10.1159/000505501. Epub 2020 Jan 20.
Gender has been proven to influence the pathophysiology and treatment of numerous diseases, including kidney diseases and hormonal dysfunction like hyperparathyroidism. Thus, higher parathormone levels have been demonstrated in women with end-stage kidney disease, when compared to men.
We questioned whether female gender is associated with an increased risk for parathyroid nodular hyperplasia and necessary parathyroidectomy in dialysis patients and assessed demographics as well as outcome data for women and men undergoing parathyroidectomy for renal hyperparathyroidism.
One hundred and thirty patients (men = 75, female = 55) with end-stage renal disease on chronic dialysis and advanced secondary hyperparathyroidism who underwent parathyroidectomy between 2008 and 2014 at our center were analyzed retrospectively. Perioperative characteristics and short-term outcome were evaluated with respect to biological gender.
No differences could be demonstrated for patient demography, comorbidities and the perioperative course between males and females. Only preoperative calcium levels were lower in female than in male patients (2.3 ± 0.19 vs. 2.3 ± 0.26, = 0.04). There were more women, however, with cerebrovascular complications during follow-up ( = 0.04). There was no postoperative mortality, and all complications and comorbidities with exception of cerebrovascular diseases were equally distributed between female and male patients.
Overall, we could not demonstrate many significant differences between male and female patients with end-stage renal diseases, chronic dialysis and operated secondary hyperparathyroidism. Only preoperative electrolyte levels were higher in male than in female patients, and cerebrovascular complications developed more often in females than in males during long-term follow-up.
性别已被证明会影响多种疾病的病理生理学和治疗，包括肾脏疾病以及甲状旁腺功能亢进等激素功能障碍。因此，与男性相比，终末期肾病女性的甲状旁腺激素水平更高。
我们质疑女性性别是否与透析患者甲状旁腺结节性增生和必要的甲状旁腺切除术风险增加有关，并评估接受肾性甲状旁腺功能亢进甲状旁腺切除术的女性和男性的人口统计学特征以及结局数据。
回顾性分析了2008年至2014年在我们中心接受甲状旁腺切除术的130例慢性透析的终末期肾病和晚期继发性甲状旁腺功能亢进患者（男性 = 75例，女性 = 55例）。根据生物学性别评估围手术期特征和短期结局。
男性和女性在患者人口统计学、合并症和围手术期过程方面未显示出差异。仅女性患者术前钙水平低于男性患者（2.3±0.19 vs. 2.3±0.26，P = 0.04）。然而，随访期间女性发生脑血管并发症的更多（P = 0.04）。无术后死亡，除脑血管疾病外，所有并发症和合并症在女性和男性患者中分布相同。
总体而言，我们未能证明终末期肾病、慢性透析且接受继发性甲状旁腺功能亢进手术的男性和女性患者之间存在许多显著差异。仅男性患者术前电解质水平高于女性患者，且长期随访期间女性发生脑血管并发症的频率高于男性。
